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MINORITY AND WOM <br />CITY OF SOUTH BEND <br />3!bl�SS ENTERPRISE INCLUSION PROGRAM PLAN <br />RM WBE-1.0 <br />VBE OTILIZATION PLAN <br />his completed form should be supplied with Bids that o City of South Bend Public Works Projects involvi <br />Ile 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: <br />3idder. <br />1 23-014 <br />Project Name: Demolition of 1000 West Sample street <br />Base Bid Amount <br />participation. It is <br />WBE Goal: 4.65% <br />Page___�_of ) <br />Name &Address of WBE <br />Primary Contact Person <br />Namerrele hone <br />( p ) <br />Scope of Work to be Performed <br />(Attach scope/schedule If you Head additional space) <br />Dollar Amount of WBE <br />Component <br />Percentage <br />of Total <br />Bld/Pro oral <br />s,. <br />I <br />i <br />Submitted by: 9-j� �- i <br />Print Name s ature Date <br />***Goals should be calculated based on the Base Bid only.*** <br />ersion 07/19/2023 Contractor's Bid for Public Works - 9 <br />