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Local Agency Disadvantaged Business <br /> Enterprise Utilization Certification <br /> To be eligible for award of this contract the bidder must fill out and submit 1 as part of its bid proposal,_the following Disadvantaged <br /> Business.Enterprise Utilization.Certification relating to Disadvantaged Business Enterprise.(DBE)requirements.The Contracting Agency <br /> shall consider as non-responsive and shall reject any bid proposal that does not contain a DBE Certification which properly <br /> demonstrates thatthe bidder will meet the DBE participation requirements.in one'ofthe manners provided for in the proposed contract. <br /> The Bidder must submit good faith effort documentation only in the event the bidder's efforts to solicit sufficient DBE participation has <br /> been unsuccessful. The successful bidder's Disadvantage.Business Enterprise UtlizationCertification shall be deemed a part of the <br /> resulting contract. Information on certified'firmW <br /> s is available from OMBE online <br /> 'at:http://omwbe.wagov/directory-of-certified-firms/ <br /> Valley Electric Co.of Mount Vernon,Inc.... certifies.that the Disadvantaged Business Enterprise(DBE): <br /> ' (Box 1) Name of Bidder ' <br /> Finns listed below have been contacted'regarding.participation on this project If this bidder is successful on this project and is awarded <br /> the contract it Shall assure that'subcontracts or supply agreements are executed wittt those-firms where an"Amount to.be Applied <br /> l'awa(deecar is listed (If necessary use.additional sheet) n <br /> XiP.‘11/A.-tr �^ �*w, �`���� �-cr-r �� 1 'x,.-,!�..- u 3 �' $' .��tc�*a ��v- � '� 'i- ��"- <br /> . . ,. � kW ; : •j .j c Rale -' <br /> �s a' ' s„f 3 1 ?-v�s3 F, E.w€ y S , #414,�- 3#ir. a ig.- +e*"' . y,_ psi f r s r4? 0 54. <br /> 'S L llya.T o -D- ,�. _ t (f L- „rt vY,phs��i ;'�rr 1.1�sc" ipti> o i r ' € ip pit° <br /> 7t { ." < �i t@, " A lith"aq' T1s• �, . ti z:� 4 iy <br /> .. } {t*ie (01- <br /> s a ,, Man facturef eg V i 1"Q otti 1.0o�I <br /> `rod y�+:i 3"Yr' �,�. '� K t a fe $tPJ�t'� {at'G1B.L�.� ill s ;sa,-.-s: <br /> # <br /> 1« OMA CONSTRUCTION INC !BID ITEMS 1,2,5,7-18,33,34,60,66, $370,000.00 <br /> D4M2316404..-. <br /> SUB CONTRACTOR 67 <br /> 2 <br /> 3. <br /> 4. <br /> 5. <br /> 6. <br /> 7, <br /> a. <br /> 9. <br /> 10. <br /> *** <br /> Disadvantaged Business Enterprise Subcontracting Goal: 14% DBE Total S $370,000.00 <br /> Box 2 Box 3 <br /> * Regular Dealer status rnusl be approved prior to bid submittal by the Office of Equal Opportunity.Wash.Slate Dept.of Transportation.on each <br /> contract. <br /> *" See the section"Crediting DBE Participation Toward Meeting the Goal'in the Contract Document. <br /> *** The Contracting Agency Will utilize this amount to determine whether or not the bidder has met the goal.In the event of an arithmetic difference <br /> between this total and the sum of the individual amounts listed above,then the sum of the amounts listed shall prevail and the total will be revised <br /> accordingly. Participation in excess of the goal amount will be considered voluntary or race-neutral participation_ <br /> SR DOT Form 272-056A <br /> 10/2045 <br />