FORM C - SELECTED WORK CATEGORIES.pdf

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Attached to
Employee Assistance Program
Solicitation number
PS141248
Issued by
California

About this file

This is a Disadvantaged Business Enterprise (DBE) form used by a state or local government agency to track work categories and budget allocations for contract bidders and proposers. The form requires bidders to identify specific work categories they will perform either as the primary contractor or through subcontractors, along with the estimated budget and percentage of the total contract value assigned to each category. The document provides space for up to thirteen work categories, with corresponding columns for budget amounts, percentage allocations, and additional comments. Bidders must complete this form as part of their proposal submission to demonstrate how they plan to meet DBE participation goals.

The form emphasizes transparency and accountability in DBE contracting by requiring bidders to justify any work categories that do not provide opportunities for disadvantaged business enterprises and to explain why their DBE participation percentage may fall short of established goals. Bidders must provide supporting documentation where necessary to substantiate their inability to meet DBE targets. This form serves as a critical compliance document for agencies administering federal or state transportation, construction, or professional services contracts that are subject to DBE program requirements, ensuring that contracting opportunities are made available to minority-owned, women-owned, and other disadvantaged business enterprises as required by law.

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Text version

EXHIBIT 1

FORM C - SELECTED WORK CATEGORIES

Identify if Bidder/Proposer or

Subcontractor Work Categories

Bidder's/Proposer's Estimated Budget

Percentage of Estimate

Additional Comments*

Total $

*Note: Provide additional comment/justification for each work categories that does not provide opportunities for DBEs, if the percentage of contracting is not sufficient to meet the established goal; and provide supporting documentation.

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