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i <br />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 woman -owned business meets the WBE qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: 121-067 Project Name: Riverfront West Urban Neighborhood Infrastructure Improvements <br />Bidder: =jt /a,r�. ��H j T-41 Total Bid Amount: WBE Goal: 4.67% <br />Page_ _of__L_ <br />Name &Address of WBE <br />Primary Contact Person <br />(Name/Tele hone <br />p ) <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/Proposal <br />/ V1 ' <br />GD -3 �d aG3 a <br />q,&7 <br />g7 <br />Submitted by: <br />Prin ame Signet re Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 1/3/2025 Contractor's Bid for Public Works - 14 <br />