Attach J_C-112A PSC.pdf
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- Attached to
- RFP 26067 - Transportation Engineering Services
- Solicitation number
- RFP-121553
- Issued by
- Stafford County, Virginia
About this file
This is a Commonwealth of Virginia Department of Transportation form (C-112A PSC) used to certify binding agreements between prime consultants and Disadvantaged Business Enterprise (DBE) subconsultants on project-specific consultant contracts. The form documents the establishment of written quotes and preliminary binding subcontract agreements that detail the scope of work and compensation. The prime consultant and subconsultant must jointly certify that the subconsultant will perform a commercially useful function as defined under 49 C.F.R. Part 26.55(c)(d). A fully executed subconsultant agreement must be submitted to the Department within fourteen business days after contract execution and retained on file for a minimum of one year following completion of the prime consultant's contract with the Department, or for longer periods as required by applicable federal or state law and regulations.
The form requires identification of the project number, federal project number, scope of work to be performed by the subconsultant, and the dollar amount of the subconsultant agreement. Both the prime consultant and subconsultant must provide signatures, titles, and dates. The form serves as certification that the agreement represents the entire understanding between parties and that no verbal agreements or non-written representations shall modify the stated terms. This certification form is specifically designed to support DBE participation requirements on professional service project-specific consultant contracts within Virginia's transportation contracting framework.
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Text version
Form C-112A PSC June 24, 2015
COMMONWEALTH OF VIRGINIA
DEPARTMENT OF TRANSPORTATION
CERTIFICATION OF BINDING AGREEMENT
WITH
DISADVANTAGED BUSINESS ENTERPRISE FIRMS
(Project Specific Consultant Contracts)
Project No.:
Federal Project No.:
This form is to be submitted in accordance with the Department’s Special Provision DBE participation on profession service Project Specific Consultant Contracts.
It is hereby certified by the below signed Consultants that there exists a written quote, acceptable to the parties involved preliminary to a binding subcontract agreement stating the details concerning the work to be performed and the price which will be paid for the aforementioned work. This document is not intended to, nor should it be construed to, contain the entire text of the agreement between the contracting parties. This document does not take the place of, nor may it be substituted for, an official subcontracting agreement in those situations that may require such an agreement. A copy of the fully executed subconsultant agreement shall be submitted to the Department within fourteen (14) business days after contract execution.
It is further certified that the aforementioned fully executed subconsultant agreement represent the entire agreement between the parties involved and that no conversations, verbal agreements, or other forms of non-written representations shall serve to add to, delete, or modify the terms as stated.
The prime Consultant further represents that the aforementioned fully executed subcontract agreement shall remain on file for a period of not less than one year following completion of the prime's contract with the Department or for such longer period as provisions of governing Federal or State law or regulations may require. For purposes of this form, the term Prime Consultant shall refer to any Consultant utilizing a DBE subconsultant, in which they are claiming DBE credit toward the contract goal.
Consultants further jointly and severally represent that said binding agreement is for the performance of a "commercially useful function" as that term is employed in 49 C.F.R. Part
26.55 (c), (d).
Form C-112A PSC June 24, 2015
TO BE SIGNED BY THE PRIME CONSULTANT AND THE SUBCONSULTANTS
Scope of Work to be Performed:
Amount of Subconsultant Agreement to be executed: $________________________________
Prime Consultant: ___________________________________________________________
Signature: _____________________________________ Title ________________________
Date:_________________________
Subconsultant: ______________________________________________________________
Signature: _____________________________________ Title ________________________
Date:_________________________
| Scope of Work to be Performed: |
| Amount of Subconsultant Agreement to be executed: |
| Prime Consultant: |
| Title: |
| Date: |
| Subconsultant: |
| Date_2: |
| Title_2: |
| Project #: |
| Fed Proj #: |
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