DBE_Schedule_of_Participation~3.docx
DOCX document 22 KB Posted
- Attached to
- Transit-General Consulting Services
- Solicitation number
- BD-26-1030-0T100-0T100-120150
- Issued by
- Massachusetts
About this file
This document is a Schedule of Participation by Disadvantaged Business Enterprises (DBEs) form for a Massachusetts Department of Transportation (MassDOT) project, designed to track and verify participation of disadvantaged business enterprises in a competitive bidding process. The form is structured to capture details about DBE contractors, including their business activities, NAICS codes, contract amounts, and certification status, with spaces for the prime bidder's information, project number, federal aid project number, and project location.
The form requires the prime bidder to detail the specific DBE contractors, their proposed activities, contract amounts for construction work and other services/supplies, and calculate the total DBE participation percentage of the total bid. Additional compliance elements include requiring a copy of each DBE's most recent certification and an original affidavit, along with disclosure of joint check approvals or third-party material/work delivery arrangements. The document appears to be a standard procurement compliance tool used by MassDOT to ensure diverse and equitable contractor participation, with a revision date of May 8, 2013.
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Text version
SCHEDULE OF PARTICIPATION
BY DISADVANTAGED BUSINESS ENTERPRISES (DBEs)
PRIME BIDDER: ___________________________________________________________
DATE OF BID OPENING: _____________________MassDOT PROJECT NO.: ______________________
FEDERAL AID PROJECT NUMBER: ___________________________________________________________
PROJECT LOCATION: ___________________________________________________________
| Name Address and Phone Number of DBE |
| Name of Activity |
| NAICS |
Code(s) (a) DBE Contractor Activity Amount Construction Work (b) DBE Other Business Amount Services, Supplies, Material
(c) Total amount eligible for credit
Total Bid Amount
TOTALS:
| $ |
| DBE Percentage of Total bid: |
A copy of the DBE’s most recent certification and an original affidavit must be attached to this document.
Is a Joint Check Approval being submitted for any of the above? □ Yes □ No Will any of the contractors listed above be using a third party to deliver materials or perform any portion of work? □ Yes □ No (i.e. manufacturing)
SIGNATURE:___________________________________________ DATE________________________________
NAME AND TITLE (PRINT):_____________________________________________________________________
EMAIL ADDRESS: _______________________________________TEL NO.:_____________________________ Rev’d 5/8/13
File details come from the government source that posted it. Updated .