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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN - <br />FORM WBE-1.0 <br />WBE UTILIZATION PLAN <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE participation. It is <br />the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: 123-014 Project Name: Demolition of 1000 West Sample Street <br />Bidder: Green Demolition Contractors Inc. Base Bid Amount: WBE Goal: 4.65% <br />Page-2—of 2 <br />Name 8 Address of WBE <br />Primary Contact Person <br />Scope of Work to be Performed <br />Dollar Amount of WBE <br />Percentage <br />of Total <br />Name/Tele hone <br />( p ) <br />(Attach scope/schedule need additional space) <br />Component <br />Bld/P sal <br />San Corporation <br />Sandra Smith <br />Trucking & Hauling <br />$27,872.00 <br />6.5% <br />1112 East Summit St <br />219-299-6830 <br />Crown Point, Indiana <br />46307 <br />Submitted by: _ Michael Brough <br />Print Name <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 07/19/2023 Contractor's Bid for Public Works - 9 <br />2-12-2024 <br />Date <br />