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0.- <br />WBECITY OF SOUTH BENDMINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLANFORM WBE-1.0 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: 125-005 Project N1ame: 2025 Street & Sewer Material Bid <br />Bidder: l��s( 4"7 YA SiJil�i� to Total Bid Amount: WBE Goal: N/A_ <br />Page 4—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 sal <br />1 <br />��rlc• �,J�S �fec� <br />G GD i Y1C� stw 1 . <br />Submitted by' ``;v, Date <br />Print Name S�aature <br />Version 07/1912023 Contractor's Bid for Public Works - 14 <br />