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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN 'Y,. FACE <br />; a` <br />FORM WBE-1.0 iers <br />WBE UTILIZATION PLAN <br />***Goals should be calculated based on the Base Bid only.*** <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: 123-063R Project Name: Cleveland Road at Portage Road Traffic Signal Improvements <br />Bidder: �ffL Zna bOCA Iona Total Bid Amount: � � uoo . oo WBE Goal 4.58% <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/Pro osal <br />Ccv, nioltamct <br />Comi Boo 1,13 I' <br />AU9-aU)�--ag03 <br />Cor�dv►iU00,co <br />5% <br />Submitted by: TOA n L �oy i tZ <br />Print Name Signa re Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 5/20/2024 Contractor's Bid for Public Works - 10 <br />