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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 />rhis 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: 126-030 Project Name: River Glen Office Building Demolition <br />Bidder: -E�j61 �} +�A( e �JV Total Bid Amount: eeen `) .� �-�' MBE Goal: 1.29% <br />Page 11 of i <br />Name & Address of MBE <br />l <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 />Bid/Proposal <br />Submitted by: <br />Print Name Signature Date <br />***Goals should be calculated based on the Base Bid only.*** <br />