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CITY OF SOUTH BEND': <br />•ibY:j • ' <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM WBE-1.0'?�S': <br />WBE UTILIZATION PLAN <br />h•" '.�`''':...... <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: <br />Bidder: <br />124-023A <br />Project Name <br />.-sr- <br />tomi Park JrhO ve _ Pool House L <br />Total Bid Amount: <br />1M Goal: 4.56% <br />a of <br />Names a Address of WBE <br />Primary Contact Person <br />(Namef telephone) <br />�� .._------� <br />Scope of Work to b�,ea[fo�med• _^-" = <br />f�tetr�w� fseh�iif8'VWU need additional space) <br />Dollar Amount of WBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />San Corporation <br />1112 E. Summit Street <br />Crown Point, IN 46307 <br />Sandra Smith <br />(219) 299-6830 <br />Trucking <br />$8,873.60 <br />i <br />4.7% <br />Submitted by: <br />Michael J. Brough February 24, 2025 <br />Print Name Signature Date <br />*"**Goals should be calculated based on the Base Bid only.*"* <br />Version 6/20/2024 Contractor's Bid for Public Works - 9 <br />