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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-1.0 <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 or woman business meets the MBE qualifications. <br />***Goals should be calculated based on the Base Bid only."' <br />Project Number: <br />Bidder: <br />125-038 Project Name: Demolition of 4022 Old Cleveland Road <br />Green Demolition Contractors Total Bid Amount: <br />$39,800.00 MBE Goal: 1.3% <br />Page of <br />Name & Address of MBE <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 MBE <br />Component <br />Percentage <br />of Total <br />INC Of <br />1st Class Logistics LLC <br />2213 Saint Charles Avenue <br />South Bend, IN 46614 <br />Berard Coutee <br />Trucking & Hauling <br />$597.00 <br />0 <br />1./05 <br />Submitted by: Michael J. Brou h / June 23, 2025 <br />9 <br />Print Name Sign u Date <br />***Goals should be calculat ased on the se Bid on y.*** <br />Version 3/15/2024 Page - 86 Public Works Quote <br />