Attachment K-4 - ACDBE Commitment Form - Package 1.pdf

Airport Concessions Disadvantaged Business Enterprise

(ACDBE) Commitment Form

WCAA ACDBE Commitment Form - Revised 12/4/2018 Page 1 of 1

The proposer commits to and further represents that the proposed level of ADBE participation, as outlined in the enclosed Vendor Summary Form, for this project is _______% and confirms the proposed participation of ACDBEs as set forth on the attached Vendor Information Forms.

The proposer commits to and further represents that the proposed level of ACDBE participation, as set forth in the enclosed Vendor Summary Form, for this project is _______%. However, this level of ACDBE participation is less than the goal established for this project. The proposer has attached:

a. Vendor Summary Form showing the level of ACDBE participation the proposer has been able to obtain, supplemented with Vendor Information Forms confirming the proposed participation of ACDBEs; and

b. Documentation of the proposer's Good Faith Efforts to achieve the goal established for this project. This documentation shall include enough to show that all necessary and reasonable steps were taken to achieve the ACDBE goal.

Proposer understands that its ACDBE commitment percentage continues through the entire duration of the contract and if the ACDBE achievement falls below the amount committed, Good Faith Efforts will be required.

I hereby affirm that the above information is true, correct, and complete to the best of my knowledge. I further understand and agree that, this document shall be attached thereto and become a binding part of the concession contract. I further attest that the proposed ACDBE firms will perform the portion of the contract described on its Vendor Information Form. Furthermore, in accordance with 49 CFR 26.53, the work committed to the proposed ACDBEs shall not be performed by others without prior written consent of the WCAA DBELO.

Authorized Representative - Printed Name Title Signature Date

______________ Authorized Representative - Printed Name Title Signature Date

Note: A facsimile/copy of the executed signature page may be accepted at bid deadline. However, the original executed signature page must be provided to the Airport Authority within two (2) business days after bid deadline.

This page must be completed by the proposed prime contractor to indicate the Airport Concessions Disadvantaged Business Enterprise participation commitment amount, as a percentage of anticipated gross revenues.

The undersigned, as a representative of entity, ____________________________________________, submitting a proposal for the ________________________________________________ opportunity, hereby acknowledges that the ADBE goal established for this project is _______% of the total cost of the contract.

Select from one of the two certifications noted below:

WAYNE COUNTY AIRPORT AUTHORITY ATTACHMENT