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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM WBE-1.0 <br />WBE UTILIZATION PLAN <br />i ms compieTea Torm snouia be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE participation. It <br />is the bidder's sole responsibility to verify whether any listed minority or woman business meets the WBE qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: 125-017 Project Name: Urban Tree Nurse Site Improvements <br />Total Bid <br />Bidder: CC3Y s� (-c.y� 5�c� (,vex Z Amount: T) ©� ,�� WBE Goal: p <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/Proposa <br />Ica <br />i CSC i � j � • <br />he l I <br />D�ir�;C3,1< <br />X CcA �-� U� c� �j�g /U <br />a° o <br />Zc')� <br />`7,C�fi 40 <br />} <br />Submitted byPA C�� <br />Print Name <br />Si ure <br />***Goals should be calculated based on the Base Bid only.*** <br />Date <br />