DBE_Letter_of_Intent.pdf

LETTER OF INTENT

(To be completed by the DBE – Page 1 of 2)

TO: ____________________________________________________________________ (Prime Bidder)

FROM: _________________________________________________________________ (DBE Firm)

RE: PROJECT NO.: ________________ FEDERAL AID PROJECT NO.: _______________________

PROJECT LOCATION:____________________________________________________________

DATE OF BID OPENING:__________________________________________________________

I, _____________________________, authorized signatory of the above-referenced DBE firm hereby declare:

1. My company is currently certified as a Disadvantaged Business Enterprise (DBE) by the Massachusetts Supplier Diversity

Office (“SDO”), formerly known as the State Office of Minority and Women Business Assistance (SOMWBA), to perform work in the following NAICS code(s): ________________________________________ as a: (check all applicable;

additional guidance is available at Title 49, Code of Federal Regulations, Part 26.55):

( ) CONTRACTOR ( ) REGULAR DEALER ( ) BROKER

( ) MANUFACTURER ( ) TRUCKING OPERATIONS ( ) PROFESSIONAL SERVICES

2. My firm has the ability to manage, supervise and perform the activity described on page 2 of this Letter of Intent. If you are awarded the contract, my company intends to enter into a contract with your firm to perform the items of work or other activity described on the following sheet for the prices indicated.

3. There have been no changes affecting the ownership, control or independence of my company since my last certification review on ______________ ___, 20___. If any such change is planned or occurs prior to my company's completion of this proposed work, I will give prior written notification to your firm and to the Massachusetts Department of Transportation (“MassDOT”)

Office of Civil Rights and SDO.

4. My DBE certification has not been revoked nor has it expired nor has there been any change in the minority status of my company.

5. For the purpose of obtaining subcontractor approval from MassDOT, my firm will provide to you:

A. The following construction work:

(i) a resume, stating the qualifications and experience, of the superintendent or foreperson who will supervise on site-work;

(ii) a list of equipment owned or leased by my firm for use on this project; and

(iii) a list of all projects (public or private) upon which my firm is currently performing, is committed to perform, or intends to make a commitment to perform. I shall also include, for each project: the name and telephone number of a contact person for the contracting authority, person, or organization; the dollar value of the work; a description of the work; and my firm's work schedule for the project.

B. The following services, materials or supplies:

(i) a written agreement and invoices for the materials or supplies, and any other documents evidencing the terms of providing such items;

(ii) information concerning broker fees and commissions for providing services or materials; and

(iii) a statement concerning whether my firm intends or will be required to use a joint check arrangement; and any other documents that may be required by MassDOT.

DBE AUTHORIZED SIGNATURE:____________________________________DATE_____________________

NAME AND TITLE (PRINT):_____________________________________________________________________

EMAIL ADDRESS: _______________________________________TEL NO.:_____________________________

LETTER OF INTENT

(To be completed by the DBE– Page 2 of 2)

DATE OF BID OPENING: ___________________________________________________________

MassDOT PROJECT NUMBER: ___________________________________________________________

FEDERAL AID PROJECT NUMBER: ___________________________________________________________

PROJECT LOCATION: ___________________________________________________________

PRIME BIDDER: ___________________________________________________________

DBE COMPANY NAME: ___________________________________________________________

Item number if applicable

Description of Activity with notations such as Services, or Brokerage, Labor Only, Material Only, or Complete

Quantity Unit Price Amount

TOTAL AMOUNT:

Please give full explanations, attach additional sheets if necessary.

I HEREBY VERIFY THAT _______________________________________________ WILL SOLELY

(DBE company name)

PERFORM THE WORK, OR PROVIDE THE SERVICES OR MATERIALS, AS DESCRIBED ABOVE.

DBE AUTHORIZED SIGNATURE: _______________________________________________________________

NAME AND TITLE (PRINT):____________________________________________________________________

TELEPHONE NUMBER: ___________________________ FAX NUMBER: ______________________________

EMAIL ADDRESS: ____________________________________________________________________________

Rev’d 3/5/2019

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