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CITY OF SOUTH BEND Vill <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 -owned business meets the MBE qualifications. <br />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: 125-014 Project ,N,ame: Rabbi Shulman Apartment Building Demolition <br />Bidder: ,Z/j j,4/ ,4 4r fA+.�W Total Bid Amount: %� 79-/ � ('00 � QO MBE Goal: 1.3% aa <br />Page___L_of 1 <br />Name &Address of MBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scope/schedule if you reed additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />Ketifid <br />10.4 re ✓5 <br />f <br />Al <br />Submitted by: Ile /" /r i <br />4ntme 1JSighatur4.00, Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 5/20/2024 Contractor's Bid for Public Works - 8 <br />