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x n <br />CITY OF SOUTH BEND 19 <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-1.0 �..\�;✓ <br />MBE UTILIZATION PLAN <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is <br />the 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-"4R Project Name: Demolition of 1000 West Sample Street <br />Bidder: Green Demolition Contractors. Inc. _ Base Bid Amount: 152&000.00 MBE Goal: 1.39% <br />Page 1 off <br />Name &Address of MBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach soope/schedute'rf you need additional space) <br />Mar Amount of MBE <br />Component <br />Percentage <br />Of Total <br />B' I <br />1 st Class Logistics <br />2213 Saint Charles <br />South Bend, IN 46601 <br />Bernard Coutee <br />Trucking & Hauling <br />(Dump Truck) <br />$7,392.00 <br />1.4% <br />Submitted by: Michael Bro h _ 3-25-2024 <br />Print Name ignature Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 07/19/2023 Contractors Bid for Public Works - 8 <br />