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C. <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: 124-001 <br />Project Name: <br />Bend - SBCSC City Hall Renovation <br />_South <br />Bidder: MICHUDA-CRUZ <br />Indiana JV LLC <br />Total Bid Amount: WBE Goal: <br />3.30 <br />Page <br />of <br />Name &Address of WBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed Dollar Amount of WBE <br />(Attach scope/schedule if you need additional space) Component <br />Percentage <br />of Total <br />Bid/Proposal <br />10-22-24 <br />Submitted by: Josef Michuda <br />Print Name <br />Signatu Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 03/15/2024 Contractor's Bid for Public Works - 11 <br />