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. ypUTH BE' <br />o <br />CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN �`''" r <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 />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: 123-012 Project Name: High Street Sidewalk Project <br />Bidder: Total Bid Amount: S-5, _ WBE Goal: �:10 io 5.13 % <br />Page of <br />Name & Address of WBE <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 WBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />%J <br />�Cc\Cab <br />I r.IM <br />1. CCOY141,c <br />35 <br />Submitted by: l \�Pl ��f�`� �r ,�� . ,I%j /U4" ��— : tiI // i`/ <br />Print Name Sign ture ! Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 07/19/2023 Contractor's Bid for Public Works - 9 <br />