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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE4.0 <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: 122-016C Project Name: Bercliff Estates Sewer Separation Project <br />Bidder: HRP Construction Inc. Total Bid Amount: $ 691,539.00 MBE Goal: 2.2% <br />_ Page 1 of 1 <br />Name &Address of MBE <br />Primary Contact Person <br />(Name/Tetephone) <br />Scope of Work to be Performed <br />(Attach scopefschedute if you need additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />V & R Trucking, Inc. <br />1845 N. Elmer Street <br />Veda Godette <br />Hourly Trucking <br />$13,300.00 <br />1.9% <br />South Bend, IN 46628 <br />574-234-1268 <br />C Lee Construction Svc <br />1011 S. Lake St. <br />Chi Lee <br />p <br />Hourly Trucking -Asphalt <br />$ 2 000.00 <br />0 <br />.3 /o <br />Gary, IN 46403 <br />219-746-7288 <br />Submitted by: Matthew D. Cain, President <br />Print Name Signature <br />***Goals should be calculated based on the Base Bid only` ' * <br />Version 07/19/2023 Contractor's Bid for Public Works - 9 <br />December 12, 2023 <br />Date <br />