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UULUJIyi I CI IVCIUpe IU.J/D/Lrom-OLry-YDO I-H17OJ-4 I I 4TOJDODC4U <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 /> 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: 20,899,040.68 <br /> Bid Amount: 20,899,040.68 <br /> Total DBE Percentage: 7.03% <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 /> Exhibit A Page 30 of 63 <br />