w37503083_(3).docx

DOCX document 69 KB Posted

Attached to
Emergency Bypass Pumps Rental & Delivery (Disaster Contract) State and local contract opportunity
Solicitation number
ITB 25-075
Issued by
Lee County, Fruitville CDP, Florida

About this file

This document is a State of Florida Department of Transportation (FDOT) Professional Services DBE or Small Business Commitment Form for a contract opportunity. The form is designed to track and document Disadvantaged Business Enterprise (DBE) and Small Business participation in a professional services contract, requiring detailed reporting of work types, percentages, and business classifications for prime consultants and subconsultants/subvendors.

The form provides a structured mechanism for contractors to demonstrate their commitment to DBE and Small Business inclusion, with specific instructions to verify business status through FDOT's online directories. Contractors must comprehensively account for 100% of contract work, categorizing each firm's participation by business type (DBE, Small Business, or Non-DBE/Non-Small Business). The document emphasizes that the number one ranked firm is required to enter DBE participation in the Equal Opportunity Compliance (EOC) System after contract award and for any subsequent amendments or task work orders.

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Emergency_Bypass_Pumps_Rental_&_Delivery_(Disaster_Contract)_(Addendum_#1_Revision).pdf PDF
Emergency_Bypass_Pumps_Rental_&_Delivery_(Disaster_Contract)_(Addendum_#1_Revision).pdf PDF
275-030-11-DBE_BID_PACKAGE_INFORMATION.pdf PDF
370-040-24-MBE_PLANNED_UTILIZATION.pdf PDF
575-060-13-NON-COLLUSION_DECLARATION_AND_COMPLIANCE_WITH_49_CFR_29.pdf PDF
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FHWA-1273_(10_23)_.pdf PDF
525-010-46-LAP_CERTIFICATION_OF_CURRENT_CAPACITY.pdf PDF
FHWA-1273_(10_23)_.pdf PDF
Local_Preference_Affidavit.pdf PDF
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2_CFR_Part_200_app_II_(up_to_date_as_of_4-28-2025).pdf PDF
375-030-30-TRUTH_IN_NEGOTIATION_CERTIFICATION.pdf PDF
375-030-33-DISCLOSE_OF_LOBBY_ACTIVITIES.pdf PDF
525-010-46-LAP_CERTIFICATION_OF_CURRENT_CAPACITY.pdf PDF
Local_Preference_Affidavit.pdf PDF
370-040-24-MBE_PLANNED_UTILIZATION.pdf PDF
375-030-32-CERTIFICATION_REGARDING_DEBAREMENT,_SUSPENSION,_INELIGIBILITY..._.pdf PDF
375-030-34-DISCLOSURE_OF_LOBBYING_ACTIVITIES.pdf PDF
575-060-13-NON-COLLUSION_DECLARATION_AND_COMPLIANCE_WITH_49_CFR_29.pdf PDF
Checklist_Solicitation.xlsx XLSX spreadsheet
SRF_SupplementaryConditions_EM_Contract_(August_2022).pdf PDF
375-030-31_Affidavit_Regarding_Labor_and_Services.docx DOCX document
375-040-84-LAP_PROFESSIONAL_SERVICES_TERMS.pdf PDF
Checklist_Solicitation.xlsx XLSX spreadsheet
SRF_SupplementaryConditions_Construction_Contract_(August_2022).pdf PDF
275-030-11-DBE_BID_PACKAGE_INFORMATION.pdf PDF
2_CFR_Part_200_app_II_(up_to_date_as_of_4-28-2025).pdf PDF
375-030-33-DISCLOSE_OF_LOBBY_ACTIVITIES.pdf PDF
Notice_of_Award.docx DOCX document
375-030-32-CERTIFICATION_REGARDING_DEBAREMENT,_SUSPENSION,_INELIGIBILITY..._.pdf PDF
375-030-34-DISCLOSURE_OF_LOBBYING_ACTIVITIES.pdf PDF
Notice_of_Award.docx DOCX document
SRF_SupplementaryConditions_EM_Contract_(August_2022).pdf PDF
375-030-30-TRUTH_IN_NEGOTIATION_CERTIFICATION.pdf PDF
375-030-31_Affidavit_Regarding_Labor_and_Services.docx DOCX document
375-040-84-LAP_PROFESSIONAL_SERVICES_TERMS.pdf PDF
BABA_Form.pdf PDF
SRF_SupplementaryConditions_Construction_Contract_(August_2022).pdf PDF
ITB_25-075_Well_Pump-Motor_Repair_and_Replacement_(Addendum_#1_Revision).pdf PDF
ITB_25-075_SAMPLE_AGREEMENT.pdf PDF
Exhibit_A_Scope_of_Work.pdf PDF
Show all 42

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Text version

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:
Project Description:
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:

Prime
Type of Work

(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
Small Business
Non

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

By: Title: Date:

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