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Instructions for Disadvantaged Business DBE Enterprise Bid Item Breakdown Form <br /> P (DBE) <br /> Box 1: Provide the Contract Number as stated in the project information webpage. , <br /> Box 2: Provide the Name of the project as stated in the project information webpage. <br /> Box 3: Provide the Name of the bidder(Proposal holder)submitting Bid. I <br /> Box 4: Provide the name of the prime contractor's representative available to contact regarding this form. <br /> Box 5: Provide the phone number of the prime contractor's representative available to contact regarding this form. <br /> Box 6: Provide the email of the prime contractor's representative available to contact regarding this form. <br /> Column 1: Provide the Name of the Disadvantaged Business Enterprise (DBE) Firm. DBE Firms can be found using the <br /> search tools under the Firm Certification section of the Diversity Management and Compliance System <br /> (DMCS)webpage https://wsdot.diversitycompliance.com. <br /> Column 2: Provide the Bid Item Number(as it appears in the engineer's estimate bid check report) available on the project <br /> information webpage. <br /> Column 3: If the DBE is performing only part of the bid item, mark"Partial". If the DBE is performing the entire bid item, <br /> mark"Complete". <br /> Column 4: Provide the estimated quantity for the specific bid item. For trucking firms, use hour or another unit of measure. <br /> Column 5: Provide a description of the work to be performed by the DBE. I <br /> Column 6: Provide the price per unit and specify the type of unit used. For trucking firms, use hour or another unit of <br /> measure. <br /> Column 7; Provide the estimated total unit cost amount per bid item. 1 <br /> Column 8: Provide the amount of the bid item being used to fulfil the DBE goal. The work to be performed must <br /> be consistent with the Certified Business Description of the DBE provided in the DMCS webpage https://wsdot. <br /> diversitycompliance.com. Mobilization up to 10% is acceptable. If mobilization is more than 10% additional information <br /> and/or justification may be requested. The total amount shown for each DBE shall match the amount shown on the DBE <br /> Utilization Certification Form. <br /> Use Additional Sheets if necessary. . • <br /> I <br /> I <br /> I <br /> I <br /> DOT Form 272-054 Page 20 of 30 <br /> Revised 09/2020 <br />