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ier N <br />CITY OF SOUTH BEND �3�: <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />:.,r- ... <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 <br />Bidder: <br />119-031C Project Name: Drewry's Brewery Cleanup, Phase I <br />ALPINE DEMOLITION SERVICES LLC Base Bid Amount: <br />MBE Goal: 1.30% <br />Page of. <br />Name & Address of MBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />{Attach scope/schedule ii you need additional space] <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Pro osaI <br />Submitted by: KELLI PAWLIK, PRESIDENT <br />Print Name Signature <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 07/19/2023 Contractor's Laid for Public Works - 8 <br />3/2GI24 <br />Date <br />