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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 />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 minority -owned business meets the WBE qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: 124.026 Project Name: 2025 Guardrail Improvements Project <br />Bidder: C- I e0., Ur m . rA/ c Total Bld Amount: $ 10 $ r Co S to <br />Division 3 - WBE Goal: 5.56% Division 3 Bid Amount $ 3, & -, :? Page 2 of 2 <br />Name & Address of MBE <br />Primary Contact Person <br />(Namefrelephone) <br />Scope of Work to be Performed <br />(Attach scopelschedule If you need additional space) <br />Col far Amount of MBE <br />Component <br />Percentage <br />of Total <br />BldlProposal <br />Pr�wowluyi k tf�wy <br />4 <br />.0'1 <br />Submitted by: 9-n IA- . rot✓ / 16 �b A <br />Print Name igna Date <br />Version 1/3/2025 Contractors Bid for Public Works - 14 <br />