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CITY OF SOUTH BEND f. <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-1.0 <br />MBE UTILIZATION PLAN <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is <br />the bidder's sole responsibility to verify whether any listed minority or woman business meets the MBE qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: <br />Bidder: <br />124-037 Project Name: Wastewater Treatment Plant Administration Building 15 Office Remodel <br />Larson -Danielson Construction Co. Inc. Total Bid Amount: 115,830.00 MBE Goal: 1.8% <br />Page 1 of 1 <br />Primary Contact Person Scope of Work to be Performed — Dollar Amount of MBE Percentage <br />Name & Address of MBE (Name/Telephone) (Attach scope/schedule if you need additional space) Component of Total <br />Bid/Proposal <br />Performance Plus <br />2106 S. Franklin St. Joe Horst Final Cleaning <br />South Bend, IN 46613 <br />DA Dodd Mechanical <br />2516 North Home Street Jason Hobbs HVAC Mechanical <br />Mishawaka, IN 46545 ` <br />SEE ATTACHED FORMS <br />FOR OTHER COMPANIES <br />SOLICITED <br />Submitted by: Chad Becker, FSG Project Manager <br />Print Name Signature <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 3/15/2024 Page - 23 Public Works Quote <br />1,088.00 1 1.05% <br />5,868.00 1 5.65% <br />August 12, 2025 <br />Date <br />