DBE_Tracking_Form_for_Invoicing.docx

DOCX document 27 KB Posted

Attached to
Transit-General Consulting Services
Solicitation number
BD-26-1030-0T100-0T100-120150
Issued by
Massachusetts

About this file

The document is a DBE (Disadvantaged Business Enterprise) Tracking Form for Invoicing issued by MassDOT (Massachusetts Department of Transportation) for its Rail and Transit Division (RTD). The form is a mandatory submission requirement for consultants, who must complete and attach it to each invoice to document their DBE participation during a specific invoicing period. The form captures detailed information about DBE firms involved in the contract, including the firm name, task order number, services provided, amounts paid during the current period, and cumulative payments.

The tracking form serves as a mechanism to monitor and verify DBE participation in the contract, requiring consultants to report the total invoice amount, percentage of DBE participation for the current invoice, and cumulative DBE participation to date. Consultants must certify the accuracy of the information through an authorized representative's signature, which includes their name, title, and the date of certification. This document is critical for ensuring transparency and accountability in meeting DBE participation goals and tracking the financial contributions of disadvantaged business enterprises throughout the contract's duration.

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Text version

DBE Tracking Form for Invoicing Consultants are required to complete and submit this form with each invoice to MassDOT RTD. This form documents Disadvantaged Business Enterprise (DBE) participation associated with the invoicing period.

Consultant Firm Name: ___________________________________________ RTD Contract Number: _____________________________________________ Invoice Number: _________________________________________________ Invoice Date: ___________________________________________________ Invoice Period Covered (From – To): ________________________________ DBE Participation Details

DBE Firm Name
Task Order #
Service Provided
Amount Paid This Period ($)
Cumulative Amount Paid ($)
% of Total Invoice

Total Invoice Amount: $___________________________ Total DBE Participation This Invoice (%): ________________________ Cumulative DBE Participation to Date (%): ________________________

I certify that the information above is accurate and reflects the DBE participation for this invoicing period.

Authorized Representative Signature: ____________________________ Name: ____________________________ Title: ______________________ Date: ________________

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