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CITY OF SOUTH BEND <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 or woman business meets the MBE qualifications. <br />Project Number: 124-041 Project Name: 2024 Brick Pavement Spot Repairs _ <br />Bidder: Selge Construction Co., Inc. Total Bid Amount: $ 226,523.00 MBE Goal: N/A <br />Page 1 of 1 <br />Primary Contact Person Scope of Work to be Performed I Dollar Amount of MBE Percentage _I <br />Name & Address of MBE I of Total <br />(Namelrelephone) (Attach scope/schedule if you need additional space) Component Bld/Pro osal <br />1st Class Logistics <br />2213 St. Charles Ave <br />South Bend, IN 46614 <br />Submitted by: <br />Bernard Coutee I Trucking <br />574-993-0071 j <br />Robert Kuhns, Project Engineer—�a <br />Print Name <br />Version 06/01/2022 <br />Signature <br />Page - 21 <br />$1,000.00 1 0.44% <br />5.28.24 <br />Date <br />Public Works Quote <br />