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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM WBE-1.0 <br />, <br />WBE UTILIZATION PLAN <br />***Goals should be calculated based on the Base Bid only.*** <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE <br />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: 1123-063R Project Name: Cleveland Road at Portage Road Traffic <br />Bidder: Cat- �IJU L' 1 IUf ���ii Total Bid Amount: � • �� <br />WBE Goal: 4.58% <br />Page 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 />Core 50 (t— <br />IndiOInO� <br />WMI Bowl,,A) <br />U9-JUA-3q0 <br />cofl4 104- <br />PA) 0,00 <br />Submitted by: �an L WV:�t/ ��✓ <br />Print Name Signature ate <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 5/20/2024 Contractor's Bid for Public Works - 10 <br />