12-DC SBE Supplier CUF 11-07-25.pdf

PDF 160 KB Posted

Attached to
Terminal F Phase 2 Ticketing, Processing, Garage, & Roadways
Solicitation number
PA2045
Issued by
Dallas County, Texas

About this file

This is a Small Business Enterprise (SBE) Supplier Commercially Useful Function (CUF) Questionnaire Form issued by the Business Development Department of DFW International Airport in Texas. The form is designed to determine how supplier participation is counted toward Small Business Enterprise goals in accordance with 49 CFR Part 26.55. Suppliers must identify their type of operation—Manufacturer, Regular Dealer, Distributor, Broker, or Manufacturer's Representative—and answer corresponding questions to establish their commercially useful function. The form references the related Terminal F Phase 2 Ticketing, Processing, Garage, & Roadways Design-Build contract valued at $650,000,000, which carries Disadvantaged Business Enterprise (DBE) goals of 26% for Construction services and 18% for Design services with a four-year contract term.

Suppliers and prime contractors must complete this certification form to demonstrate compliance with the Airport Board's SBE program requirements. The form requires original signatures from both the prime contractor and supplier, and both parties must affirm under penalty of perjury that the information provided is true and correct. The Business Development Department reserves the right to conduct audits of submitted SBE information, verify compliance through responsibility determinations on future contracts, and pursue suspension, debarment, or forfeiture of profits for non-compliance. Any suspected false, fraudulent, or dishonest conduct may be reported to the Airport Board's Department of Audit Services, the State Attorney General, or the United States Attorney. The form was last revised on November 13, 2025, and references the USDOT Regular Dealer/Distributor Affirmation Form for suppliers classified as Regular Dealers or Distributors.

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Text version

This form may be photocopied. Original signatures are required for each submission of this form REV 11/13/2025

Business Development Department

QUESTIONNAIRE FORM

COMMERCIALLY USEFUL FUNCTION (CUF)

BASIC QUESTIONS FOR HOW SUPPLIER PARTICIPATION IS COUNTED

Before completing this form please reference FAA’s 49 CFR Part 26.55

Checkmark the TYPE of operation you are performing:

-Manufacturer -Regular Dealer -Distributor -Broker -Manufacturer’s Rep

Type Yes No

Questions

Manufacturer 100%

Is the primary function of your business to manufacturer construction products?

Do you maintain a factory or establishment that produces on the premises the materials, supplies, equipment that is required under contract?

Do you bear the RISK OF LOSS of any of the material, supplies, equipment?

Regular Dealer 60%

Please see and complete the SBE Regular Dealer/Distributor Affirmation Form USDOT Regular Dealer/Distributor Affirmation Form (transportation.gov)

Distributor 40%

Please see and complete the SBE Regular Dealer/Distributor Affirmation Form USDOT Regular Dealer/Distributor Affirmation Form (transportation.gov)

Broker (Fees & Commissions

100%)

Do you act as intermediary between two or more firms for the acquisition of supplies, materials, or equipment for a fee?

Manufacturer’s Representative

(Fees & Commissions 100%)

Do you sell products for one or more manufacturers?

Are you representing a manufacturer for a fee or commission?

Do you earn a commission for sell of products by a firm or manufacturer?

The above information is true and correct to the best of my knowledge and belief. Failure to provide accurate and complete information or exercise positive, Good Faith Efforts (GFE), (as defined by the Board’s SBE Program) in support of the Board’s Small Business intent and objective may result in being considered non-compliant to the Board’s requirements. All contractors and subcontractors must comply with Airport Board's SBE requirements set forth in 49 CFR Part 26.55. Business and Development Department (BDD) reserves the right to apply legal and contract remedies available under federal, state and local law, including but not limited to, responsibility determinations in future contracts, suspension and debarment procedures and forfeiture of profits as provided for elsewhere. BDD reserves the right to ensure compliance with the Board’s SBE programs as deemed necessary including but not limited to audits of submitted SBE information applicable to the Contractor/Subcontractors participating on the contract. BDD may report any suspected false, fraudulent or dishonest conduct in the commitment and attainment of any SBE goal to the Airport Board’s Department of Audit Services or any applicable enforcement agency, including the State Attorney General and the United States Attorney.

PRIME CONTRACTOR (Print)__________________________________ SUPPLIER (Print)____________________________

Sign & Date_____________________________ ____/___/____ Sign & Date______________________________ ___/___/___ https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.transportation.gov%2Fsites%2Fdot.gov%2Ffiles%2F2024-06%2FDBE%2520Regular%2520Dealer-Distributor%2520Affirmation%2520Form-%2520OMB%2520Control-508v3.pdf&data=05%7C02%7Ccjeter%40dfwairport.com%7Cb2c5934f8f69440825d108dcdf3be755%7Cb8b2085ab3c4408fab3e40ab7c8fa58e%7C0%7C0%7C638630695601345999%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=beFWxafvq1PDqYZJnJgqV82SIWCrmJPAEqTfC3yzpFo%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.transportation.gov%2Fsites%2Fdot.gov%2Ffiles%2F2024-06%2FDBE%2520Regular%2520Dealer-Distributor%2520Affirmation%2520Form-%2520OMB%2520Control-508v3.pdf&data=05%7C02%7Ccjeter%40dfwairport.com%7Cb2c5934f8f69440825d108dcdf3be755%7Cb8b2085ab3c4408fab3e40ab7c8fa58e%7C0%7C0%7C638630695601345999%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=beFWxafvq1PDqYZJnJgqV82SIWCrmJPAEqTfC3yzpFo%3D&reserved=0

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