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O y0UNC \ <br />N <br />CITY OF SOUTH BEND z <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN_,�2 <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 -owned business meets the MBE qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: <br />Bidder: <br />Project Name: Byers Softball Complex Improvements Phase 1 <br />PREMIUM CONCRETE SERVICES Total Bid Amount: $ 2>649,178.00 <br />MBE Goal: <br />Page 1 of 1 <br />Name &Address of MBE <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 MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />1ST CLASS LOGISTICS <br />2213 ST CHARLES ST <br />SOUTH BEND, IN 46614 <br />BERNARD <br />COUTEE <br />(574) 993-0071 <br />TRUCKING/HAULING <br />$ 48,504.00 <br />0 <br />1.83/o <br />Submitted by: J'j,�X <br />Print Name Signature Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 07/19/2023 Contractor's Bid for Public Work - 16 <br />