w37503083_(3).docx

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Attached to
Sanitary Sewer Evaluation Survey Program On-Call Contractors - Manhole Lining
Solicitation number
RSQ 25-095
Issued by
Lee County, Fort Lauderdale City, Florida

About this file

Written by GovTribe AI ·

This is a Professional Services Commitment Form (Form 375-030-83) issued by the State of Florida Department of Transportation for use in conjunction with the City of Fort Myers' Sanitary Sewer Evaluation Survey Program On-Call Contractors procurement for Manhole Lining services. The form is submitted as part of the Request for Proposal process or at the time the Expanded Letter of Response is due. Bidders must identify their prime consultant and project description, then specify the expected percentage of contract fees to be utilized by Disadvantaged Business Enterprises (DBEs) and Non-DBE Small Businesses. The form requires contractors to list all proposed prime and subconsultant/subvendor work by type, designate the percentage of overall contract amount for each work category, and classify each entity as DBE, Small Business, or Non-DBE/Non-Small Business. The percentages for all prime consultants and subconsultants must total 100% when submitted to FDOT.

The form establishes that the number one ranked firm is required to enter DBE participation information in the Equal Opportunity Compliance (EOC) System subsequent to contract award and for any future contract amendments or task work orders. DBE status verification is available through the FDOT DBE Directory, while Small Business certification status for Professional Services firms can be accessed through FDOT's Internet Reports. The form includes dropdown menus for selecting work types and checkboxes for business classification, with built-in calculations showing total committed and remaining uncommitted percentages. This documentation is essential for FDOT compliance and demonstrates the contractor's commitment to meeting federal and state disadvantaged business enterprise participation goals in professional services procurement.

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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:
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 .