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ITH <br />O � <br />CITY OF SOUTH BEND z <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <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 />Project Number: 124-018R Project Name: MOMENTUM SITE IMPROVEMENTS <br />Bidder: PREMIUM CONCRETE SERVICES Total Bid Amount: $459,873.00 WBE Goal: 4.6% <br />Page of <br />Name & Address of WBE <br />Primary <br />Primary Contact Person <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 />CE HUGHES MILLING, INC <br />3113 HOLMANS IN <br />JEFFERSONVILLE, IN 47130 <br />CAROLINE <br />HUGHES <br />(812) 725-8665 <br />MILLING/THERMOPLASTIC MARKINGS <br />$21J55.00 <br />4.60% <br />Submitted by: '07A-,r x2f*Ag y 12 / /d <br />Print Name Signature Date <br />Version 09/29/2024 Contractor's Bid for Public Works - 10 <br />