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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: 125-014 Project Name: Rabbi Shulman Apartment Demolition <br />Bidder: �n �� f?/Jt df f /11 .L/VL Total Bid Amount: T�(1D . 0(7 WBE Goal: 4.7% <br />Page__L_of <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 />Percentage <br />of Total <br />Bid/Proposal <br />An a <br />0o <br />vc <br />_ <br />rug � � <br />� 15-5 oo <br />�, /Al <br />rt <br />Submitted by: <br />Print ame Signatur Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 5/20/2024 Contractor's Bid for Public Works - 9 <br />