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t:. <br />,t. 1 <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 <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: 124-037 Project Name <br />Bidder: Larson -Danielson Construction Co., Inc. <br />Name & Address of WBE Primary Contact Person <br />(Name/Telephone) <br />Performance Plus <br />2106 S. Franklin St. <br />South Bend, IN 46613 <br />SEE ATTACHED FORMS <br />FOR OTHER COMPANIES <br />SOLICITED <br />Submitted by: Chad Becker, FSG Pr_oe_ict Manager _ <br />Print Name <br />Wastewater Treatment Plant Administration Buildin_q 15 Office Remodel <br />Total Bid <br />Amount: 115,830.00 WBE Goal: 2.8% <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Signature <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 3/15/2024 Page - 24 Public Works Quote <br />Page 1 of 1 <br />Percentage <br />Dollar Amount of WBE of Total <br />Component Bid/Proposa <br />I <br />1.05% <br />August 12, 2025 <br />Date <br />