Laserfiche WebLink
DocuSign Envelope ID-07C464C4-FDB6-434A-A01B-558064E4E858 <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> DBE FirmName: <br /> Work to Be Performed: <br /> Commitment Amount: <br /> DBE Credit Amount: <br /> Anticipated DBE Participation: 900,000.00 <br /> Bid Amount: 26,104,984.43 <br /> Total DBE Percentage: 3.440 <br /> [PAGE BREAK] <br /> Bidder Signature <br /> This section must be signed by an individual with the authority to bind the Bidder. By signing this <br /> form, as an authorized representative of the Bidder, you declare under penalty of perjury in the second <br /> degree and any other applicable state or federal laws that the statements made in this document are true <br /> and complete to the best of your knowledge. Further, you attest that you have read the Standard Special <br /> Provision Disadvantaged Business Enterprise Requirements and understand the following: <br /> CDOT shall not award a contract until it has been determined that the contract goal has been met or that <br /> you have otherwise demonstrated good faith efforts. Once your proposal has been submitted, commitments <br /> may not be modified or terminated without the approval of CDOT. If selected as the lowest apparent <br /> bidder, you shall submit a Form 1415 for each commitment listed above. If you have not met the contract <br /> goal, you will also be required to submit documentation of all good faith efforts to meet the contract <br /> goal. <br /> It is your responsibility to ensure that the selected DBEs are certified for the work to be performed <br /> and that their credit has been properly counted. For additional information and instructions on <br /> calculating DBE credit, see the Standard Special Provision Disadvantaged Business Enterprise <br /> Requirements. <br /> Exhibit A Page 24 of 59 <br />