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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-1.0 <br />M13E'1WBE PARTICIPATION <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBEIMBE participation. <br />It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's <br />owned business. <br />Project Number: 118-083B Project Name: JC Lauber Site Improvements <br />Bidder: Ritschard Bros,, Inc. Total Bid Amount: $536, 425. 75 MBEANBE coal: 7.1% <br />Page 1 of 1 <br />Name 8 Address of MBEIWE3E <br />Primary Contact Person <br />(Nameffelephone) <br />Scope of Work to be Performed <br />(Attach scopetschedule if you need additional space) <br />Dollar Amount of <br />M13ENVBE Component <br />Percentage <br />of Total <br />NdfPro osal <br />Ritschard Bros.,In <br />1204 W. Sample St. <br />South Bend, IN46619 <br />.Rachelle L. <br />Do niak <br />574-288-4777 <br />Parking Lots with onsite <br />retention & utility Hook ups <br />and sitework & improvements <br />$328,000.00 <br />61% <br />Submitted by: <br />Rachelle L. Dolniak <br />Print Name <br />4-t <br />A A, I !. , NIA September 20, 2018 <br />uro Date <br />Version 1011712017 Contractor's Bid for Public Works - 10 <br />