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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 />Project Number: 121-056 Project Name: Pure Green Farms Site Improvements <br />Bidder: f Total Bid Amount: WBE Goal: 5.1% <br />Page of <br />Primary Contact Person Scope of Work to be Performed Dollar Amount of WBE Percentage <br />Name & Address of WBE (Name/Telephone) (Attach scope/schedule if you need additional space) Component of Total <br />Bid/Proposal <br />It�� fo-� '9'It �G����Cc-Pt. �-Ii�S� {vt�� O(.cy�¢c„!r � • CJ <br />see L�1 i, <br />w; A` <br />4 d,Z- <br />Submitted by: J � -Y'�-� � / ✓2,3 <br />Print Name Signature Date <br />Version 09/29/2021 Contractor's Bid for Public Works - 10 <br />