370-040-24-MBE_PLANNED_UTILIZATION.pdf

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Attached to
Sanitary Sewer Evaluation Survey Program On-Call Contractors - Lift Station Lining
Solicitation number
RSQ 25-096
Issued by
Lee County, Fruitville CDP, Florida

About this file

This is a Minority Business Enterprise (MBE) Planned Utilization form from the State of Florida Department of Transportation for Procurement 375-040-24. The document serves as a declaration form for bidders or contractors to indicate their commitment to subcontracting a specified percentage of project costs to Minority Business Enterprises. The form requires the contractor to identify the name, title, and the percentage of project costs planned for MBE subcontracting, along with a detailed listing of the proposed MBE subconsultants or subcontractors and the types of services or commodities they will provide. The contractor must sign and date the form to certify their MBE utilization plan.

The form functions as a compliance and reporting mechanism, requiring contractors to submit Minority Business Enterprise payment certification forms to the Department for tracking and documentation purposes. This standardized form, designated 375-040-24 (Revision 03/17), is used across Florida Department of Transportation procurements to ensure diversity and inclusion in contractor selection and project execution. No specific contract values, timelines, or project details are included within this template document; rather, it is completed and submitted as part of the larger procurement package for individual state and local contract opportunities.

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Text version

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

MBE PLANNED UTILIZATION

375-040-24

PROCUREMENT

03/17

PROCUREMENT NO. FINANCIAL PROJECT NO.

(DEPARTMENT USE ONLY)

DESCRIPTION:

I, , (name) (title) of plan to subcontract at least % (percent) of the project costs on the above referenced project to Minority Business Enterprises.

If I have indicated above that a portion of the project costs will be subcontracted to MBE(s), the firms considered as proposed subconsultants/contractors and the types of services or commodities to be subcontracted are as follows:

MBE SUBCONSULTANTS/CONTRACTORS TYPES OF SERVICES/COMMODITIES

I understand that I will need to submit Minority Business Enterprises (MBE) payment certification forms to the Department for reporting purposes only.

Signed:

Title:

Date:

File details come from the government source that posted it. Updated .