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1 <br /> I Local Agency Disadvantaged Business <br /> Enterprise Utilization Certification <br /> To be eligible for award of this contract the bidder must fill out and submit,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 /> I shall consider as non-responsive and shall reject any bid proposal that does not contain a DBE Certification which properly <br /> demonstrates that the bidder will meet the DBE participation requirements in one of the 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 Utilization Certification shall be deemed a part of the <br /> r resulting contract. Information on certified firms is available from OMWBE online at: http:llomwbe.wagovidirectory-of-certified-firms! <br /> MARSHBANK CONSTRUCTION, INC. certifies that the Disadvantaged Business Enterprise(DBE) <br /> I (Box 1) Name of Bidder <br /> Firms 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 with those firms where an"Amount to be Applied <br /> Towards Goal"is listed.(If necessary,use additional sheet.) <br /> Column 1 <br /> Column 2 * Column 3 Column 4 ** <br /> Project Role Amount to <br /> Name of DBE (Prime,Joint Venture, Description of Work be Applied <br /> Certificate Nurn ber Subcontractor, P <br /> Manufacturer,Regular Towards Goal <br /> Dealer,Force Account) <br /> Clearing&grubbing,structure&obstruction removal, <br /> �• MARSHBANK CONSTRUCTION, INC. grading,highway,road,street.Highway,road,street const. <br /> ___ _...._ . ___ PRIME including new,surracing&repairs.Install&replace:storm, <br /> D1 M0011507 sewer,water lines,hydrants,watermeters&box,catch O�1��. <br /> I <br /> bac°"c,rvnholo,adit to grade,Carth r.A„M:e.a,d..,,oa,.J <br /> 2 anchored retaining wall construction. <br /> I • 3. <br /> 4. <br /> 5. <br /> 1 7. <br /> : - ---- <br /> 10. <br /> Disadvantaged Business Enterprise Subcontracting Goal 14% DBE Total <br /> 41)0,t of .,a <br /> I <br /> Box 2 l3ox 3 <br /> Regular Dealer status must be approved;trier to bid submittal by tau;Office of Equal Opportunity.Wash.State Dept.of transportation.en each <br /> contract. <br /> ` See tie section"Crediting Ul?6:Part;c.pet on Toward Meetrrty thee Goal'in die Conti(.(Document. <br /> '''' The Contracting Agency will uhlize this amount to dot r,tice v,t•ether or rot t tine bidder has ret the goalto the event of nl rn Fc ctitfeience: <br /> L....,e..n I iI;total at4.1 the suss of(ine rrilividl.al amount_listed +i;r vO.Ilion the sure of tl an.c.;rite listed shoii prevail.zed the total:•ill he avis d <br /> .ireca' i'^;uy Pl'oticipahen n excess of the goal ann>ur�i will be cue id:>.ad voluntary or;aceereut!at participation <br /> 10'20 15 <br /> ,Page 187 Local Agency Disadvantaged Business Enterprise Utilization Certification <br /> Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see WWW -Always Verify Scale <br />