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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
PROFESSIONAL SERVICES DBE OR
SMALL BUSINESS COMMITMENT FORM
375-030-83
PROCUREMENT
11/17
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
PROFESSIONAL SERVICES COMMITMENT FORM
375-030-83
PROCUREMENT
11/21
Submit this form as required in the Request for Proposal or alternatively, at the time of Expanded Letter of Response is due:
| Contract/Advertisement No.: |
| Prime Consultant: |
| Expected percentage of contract fees to be utilized by DBE(s): | %. (Combine DBE Prime and DBE subconsultants, if applicable). |
| Expected percentage of contract fees to be utilized by Non-DBE Small Businesses | %. (Combine Non-DBE Small Business Prime and Non-DBE Small Business subconsultants, if applicable). |
The proposed Prime and subconsultants/subvendors’ work is as follows:
(List each type of work separately, only one type of work per line) of overall contract amount
| DBE |
| Small Business |
| Non DBE/ |
Non Small Business
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| Subconsultant/Subvendor |
| Type of Work |
(List each type of work separately, only one type of work per line) of overall contract amount
DBE/
Non Small Business
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Total percent for Prime and Subs committed:
(Note to Consultants: should be 100% when submitted to FDOT)
Total percent for Prime and Subs remaining to be committed:
(Note to Consultants: should be 0% when submitted to FDOT)
The percentage column must total 100% for Prime and all subs.
Please note, the number one ranked firm is required to enter DBE Participation in the Equal Opportunity Compliance (EOC) System subsequent to contract award and any future contract amendments or task work orders (if applicable).
DBE status for all firms can be verified by using the DBE Directory:
https://fdotxwp02.dot.state.fl.us/EqualOpportunityOfficeBusinessDirectory/CustomSearch.aspx Small Business status for Non-Professional Services firms can be found here:
https://ssrs.fdot.gov/Reports/report/PDA%20Reports/Public%20Reports/EOOSmallBusinessCertificationReport Small Business status for Professional Services firms is located here:
https://www.fdot.gov/procurement/InternetReports.shtm#qual
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