Premier Field Development, Inc. 5/9/2016

Section 004539 Minority Business Enterprise Affidavit Although a set percentage of DBE's and WBE's subcontracts is not required in the performance of the work under this Contract, in the event that subcontractors will be used in the performance of this Contract, Bidder is required to solicit bids from DBE and WBE subcontractors as a condition to qualify for award of contract. Failure to solicit subcontract bids from DBE or WBE subcontractors or failure to list them below shall disqualify a contract Bidder from consideration from contract award. During Contract performance, or in any event prior to final payment, Bidder shall provide the City with the names and addresses of all DBE and WBE subcontractors actually awarded subcontracts and performing work under the contract. In the event that a subcontract bid is solicited and listed below and a subcontract is not awarded to the DBE/WBE so listed, Contractor shall state the reasons such subcontract was not awarded to the DBR/WBE and shall state the DBE/WBE quote together with the actual subcontract price paid and the name of the subcontractor to whom the work was subsequently awarded. I. List all DBE and WBE subcontractors and suppliers from which bids or quotes for work on this project have been solicited: Name of Firm Address Work Involved %, W o rt\QA.,\�a�\ cft-1C6\ � C\t C)-c II. Please estimate the percentage of work that will be subcontracted to DBE's and WBE's subcontractor and/or suppliers: \ F7 III. Please estimate the percentage of your force on this project that will be made up of minority group members: @ \ �o I CERTIFY THAT THE ABOVE IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND AGREE TO PROVIDE ALL ABOVE INFORMATION REQUESTED BY THE CITY REGARDING DBE/WBE SUBCONTRACT WORK. Signature: �.� Date: 44- (DC' \7% Kasch Park Soccer Fields-Synthetic Turf Replacement Phase 2 1 of 2