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This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. Itis <br />the bidder's sole responsibility to verify whether any listed minority or woman business meets the MBE qualifications. <br />Project Number: 121-045 Project Name: 2021 Contractor Paving Round 3 <br />Bidder: Rieth-Riley Construction Co., Inc. Total Bid Amount: I, �oZy. y� MBE Goal: 4.1% <br />Page 1 of 1 <br />Name & Address of MBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scopelschedule if you need additional space) <br />Dollar Amount of MBE <br />Component <br />CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MWBE-1.0 <br />x <br />1865" <br />MWBE UTILIZATION PLAN <br />" <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. Itis <br />the bidder's sole responsibility to verify whether any listed minority or woman business meets the MBE qualifications. <br />Project Number: 121-045 Project Name: 2021 Contractor Paving Round 3 <br />Bidder: Rieth-Riley Construction Co., Inc. Total Bid Amount: I, �oZy. y� MBE Goal: 4.1% <br />Page 1 of 1 <br />Name & Address of MBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scopelschedule if you need additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />Trvcki n <br />®, ®® <br />- .f <br />D <br />1 tgS'F/mtrn+. <br />371.93q, 1261�N <br />5pV4h adled, iAJ <br />IrAsc5 <br />is9.014ok eed. <br />I�o11 AA®ri <br />ry G Na <br />�®, 0® 0 ®®Qa07Weft <br />®• <br />aw-38r,l G7 <br />FP Wk n t <br />elli� <br />Submitted by: Ruben Alvarado August 10, 2021 <br />Print Name Signature Date <br />Version 01113/2021 Contractor's Bid for Public Works -10 <br />