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I <br /> I /ft Disadvantaged Business Enterprise <br /> WiWashington State <br /> Department of Transportation (DBE)Trucking Credit Form <br /> 1 PART A: TO BE COMPLETED BY THE BIDDER <br /> This form is in support of the trucking commitment identified on the DBE Utilization Certification Form submitted with the proposal. <br /> Please note that DBE's must be certified prior to time of submittal. <br /> IFederal Aid# ��- t2-I Contract# Project Name Fleming Bicycle Corridor <br /> CM— (,- (ie " P w 31�� <br /> IIf listing items by hours,or by lump sum amounts,please provide calculations to substantiate the quantities listed. <br /> Bid Item Item Description <br /> C (US tCk VD(Cau 'I 3 � <br /> -tat) co u6 <br /> I <br /> Use additional sheets as necessary. <br /> Bidder Alwa s Active Services LLC Name/Title(please print) <br /> Y Amanda Schnee/Owner <br /> Phone Fax Signature <br /> I 206 713 0759 <br /> Address 7)//iir\---' <br /> 321 NE 60th St Seattle WA 98115 <br /> I certify that the above information is complete and accurate. <br /> Email Date 11/12/2022 <br /> Alwaysactiveservices@gmail.com <br /> IPART B: TO BE COMPLETED BY THE DBE TRUCKING FIRM <br /> Note: DBE trucking firm participation may only be credited as DBE participation for the value of the hauling services, not for the <br /> materials being hauled unless the trucking firm is also recognized as a supplier of the materials used on the project and approved <br /> I for this project as a regular dealer. <br /> 1.Type of Material expected to be Crushed Surfacing Top Course <br /> hauled? <br /> 2. Number of fully operational trucksI <br /> 1 Tractor/trailers: 0 Dump trucks: 1 <br /> expected to be used on this project? <br /> 3. Number of trucks and trailers owned by 1 Tractor/trailers: 0 Dump trucks: 1 <br /> I the DBE that will be used on this <br /> project? <br /> 4. Number of trucks and trailers leased by 0 Tractor/trailers: 0 Dump trucks: 0 <br /> 111 the DBE that will be used on this <br /> prnjart'J <br /> DBE Firm Name Always Active Services LLC Name/Title(please print) <br /> Number Amanda Schnee/Owner <br /> Certification <br /> DlfOcJ�l`ls-1 <br /> Phone 206 713 0759 Fax Signature <br /> I <br /> Address 4 cii,/ ,— <br /> I <br /> 321 NE 60th St Seattle WA 98115 <br /> I certify that the above information is complete and accurate. <br /> Email Date 11/12/2022 <br /> alwaysactiveservices@gmail.com <br /> I DOT Form 272-058 Page 17 of 30 <br /> Revised 09/2020 <br /> ,_., ,a,..a �.. n,,;i.a,.., c.,.,h ....e (,P wa Tnr' Fnr nennc rnnrlitinnc ArtraPmant caa www_hxwa_Cnm - Always Verify Scale <br />