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Local Agency Disadvantaged. Business Enterprise (DBE). <br /> Written Confirmation Document <br /> As an authorized representative of the Disadvantaged Business Enterprise(DBE), I confirm that we <br /> have been contacted by thereferenced bidder with regard to the referenced project and if the bidder <br /> is awarded the contractwe will enter into an agreement with the bidder to participate in the project <br /> consistent withthe information provided in the bidder's Disadvantaged'Business Epterprise; <br /> Utilization Certification: <br /> Contract Title. <br /> Bidder's Business Name: <br /> DBE's Business Name: <br /> DBE's Business Address: <br /> DBE Signature: <br /> DBE's Title <br /> Date: <br /> The entries must be consistent with what is shown on the bidder's Disadvantaged Business <br /> Enterprise Utilization Certification. Failure to do so will result in bid rejection. See contract provision: <br /> Disadvantaged Business Enterprise Condition of Award Participation. <br /> Description of Work: <br /> Amount to be Applied Towards Goal: <br /> SR DOT Form 422-031A <br /> 1012015 <br />