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Revised 09/2020 <br />Instructions for Disadvantaged Business Enterprise (DBE) Bid Item Breakdown Form <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. <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 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. <br />Column 6: Provide the price per unit and specify the type of unit used. For trucking firms, use hour or another unit of measure. <br />Column 7: Provide the estimated total unit cost amount per bid item. <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 />DOT Form 272-054