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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 <br />involving MBE participation. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE <br />qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: 123-063 Project Name: <br />Bidder: Michiana Contracting Inc <br />Name & .Address of MBE <br />JBL Signals and Lighting LLC <br />5316 Technology Dr <br />South Bend, IN 46628 <br />®i®J <br />Primary Contact Person <br />(Name/Telephone) <br />Tanner Lelbovitz <br />574-855-2251 <br />t mi#t�� tTE Riana Contractin Inc <br />00 Print tame <br />Cleveland Road at Portage Road Traffic Signal Improvements <br />Total Bid Amount: 331,920.00 MBE Goal: 1.57% <br />Page 1 of 1 <br />Scope of Work to be Performed Dollar Amount of MBE Percentage <br />Attach scope/schedule a/schedule if you need additional space) <br />Com onent of Total <br />( p Y p �;.�/0...........I <br />Traffic Signals 88,850.00 1 26.7% <br />Signature Scott irkpatrick, President <br />Version M[7 Contractor s Bid for Public Works - 9 <br />11 /12/24 <br />Date <br />