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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 <br />is the bidder's sole responsibility to verify whether any listed minority or woman business meets the WBE qualifications. <br />***Goals should be calculated based on the Base Bid oNy.*** <br />Project Number: 126-038 Project Name: Demolition of 4022 Old Cleveland Road <br />/ rAl1! Total Bid LJ �^ <br />Bidder: d;anek !� Th Amount: 74 <br />i�O�CJ ro WBE Goal: 4.7% <br />Page_L_of_L <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/Proposa <br />I <br />Aren <br />ql,, <br />Submitted by: r1'1 ( '..— `/�f7� <br />Pri ame JSignay a Date <br />***Goals should be calculated based on the Base Bid only.*** <br />Version 3/15/2024 Page - 87 Public Works Quote <br />