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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN 6 z <br />a <br />FORM MBE-2.0, �! <br />EVIDENCE OF GOOD FAITH EFFORTS <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: 121-072 Project Name: Mishawaka Avenue Streetscape <br />Bidder: (- (nnSirucF n� (�. Jr76Total Bid Amount: �3, �faai �7?,, �7 WBE Goal: 4.96% <br />Page_L_of_L_ <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/Proposal <br />PAWk Fniler p q,ses/ M6. <br />lSSo E-. AJ,r) s+- <br />frown PO4. W b o <br />girej NeuGeb <br />�211.619,809a <br />Elec,lriccti l <br />e76 <br />Submitted by: A AQY)4� e rLAA Q &u/fte L 4 /:✓tom 2 - Il . �� <br />Print Name Signature Date <br />