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...45pUTH g�,f; <br />CITY OF SOUTH BEND tl' <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 />Project Number: 124-004 roject Name: <br />Bidder: -9,1I U Il 0 i'l Y-1--- <br />�e� <br />2024 Street & Sewer Material Bid <br />Total Bid Amount: <br />WBE Goal: N/A <br />Page I ofy-- <br />Name & Address of WBEs <br />Primary Coat ct Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scopefschedule if you need additional space) <br />Dollar Amount of WBE <br />Component <br />P rcenta <br />of T tag <br />Bid/Proposal <br />p-1 C Q((A 1xC <br />3 GQ yl�-A­a <br />Submitted by: ! ���� <br />Print Name Sign ture Date <br />Version 07/1912023 Contractor's Bid for Public Works - 14 <br />