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`,ti a r11 if, i <br />'J <br />CITY OF SOUTH BEND y <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 <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. 125-017R Project Name: Urban Tree Nursery Site Improvements <br />Total Bid -�7 a o <br />Bidder. F ,LLCAmount: 3Y� �36 / WBE Goal: c2,�'IO <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 />BidlProposa <br />I <br />1 �ro5 <br />-zo c, <br />e 61 42 <br />P999rga I&,,ely <br />-f q0?1, 3Z <br />o <br />3, d3/ <br />Submitted by: A lhmwJA&A lcL 7/-7/�Oa5 <br />Print Name Signature Date <br />***Goals should be calculated based on the Base Bid only.*** <br />