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045pU IH BE�O <br />CITY OF SOUTH BEND o <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN>� az <br />FORM WBE-1.0 <br />18(5 <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 verity 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: <br />125-042 Project Name: <br />Bidder: National Pavement Maintenance <br />2025 Microsurfacing Quote <br />Total Bid <br />Amount: <br />WBE Goal: N/A <br />Page 1 of 1 <br />Percentage <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 />of Total <br />Bid/Proposa <br />State Barricading <br />James Micals <br />i <br />24963 US 28 West <br />574-287-2078 <br />Rental of Signs and Barricades <br />N/A <br />South Bend In 46628 <br />Jewell Contracting <br />Perri Mason <br />2043 South Bend AVE574-400-919 <br />N/A <br />South Bend In 46637 <br />Submitted by: Garry Newman qa� <br />Print Name Signa re <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 1/3/2025 Page - 22 Public Works Quote <br />Date <br />7-21-2025 <br />