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CITY OF SOUTH BEND <br />MINORITY AND WOME NESS ENTERPRISE INCLUSION PROGRAM PLAN <br />ORM MBE-1.0 <br />MBE UTILIZATION PLAN <br />•rif, <br />his completed form should be supplied with Bids that p Aa+n-ta-City of South Bend Public Works Projects involving MBE participation. It is <br />Ile bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE 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 />3idder: _jlttt�� , I � -�- } (>� Base Bid Amount: :2- > �-, t -�, MBE Goal: 1.39% <br />Page C of-1— <br />Name & Address of MBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scope/schedule If you need additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />I <br />I <br />i <br />I <br />Submitted by: of <br />Print Name Si ature Dat <br />*"*Goals should be calculated based on the Base Bid only.*** <br />arsion 07/19/2023 Contractor's Bid for Public Works - 8 <br />