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I CITY OF EVERETT PUBLIC WORKS <br /> SPECIAL PROVISIONS <br /> IDOCUMENT 00 45 39-MINORITY BUSINESS ENTERPRISE AFFIDAVIT <br /> II 1 GENERAL <br /> A. Bidder shall fill out affidavit below, sign,and include with Bid. <br /> IB. Although a set percentage of DBE's and WBE's subcontracts is not required in the performance <br /> of the work under this Contract, in the event that subcontractors will be used in the performance <br /> I of this Contract., Bidder is required to solicit bids from DBE and WBE subcontractors as a <br /> condition to qualify for award of contract. <br /> I C. Failure to solicit subcontract bids from DBE or WBE subeontradors or failure to list <br /> them below shall disqualify a contract Bidder from consideration for contract award. <br /> I a Dining Contract performance, or m arty event prior to final payment, Bidder shall provide. the <br /> City with the names and addresses of all DBE and WBE subcontractors actually awarded <br /> subcontracts and performing work under the contract. <br /> I E. In the event that a subcontract bid is solicited and listed below arid a subcontract is not awarded <br /> to the DBE/WBE so listed, Contractor shall state the reasons such subcontract was not awarded <br /> to the DBR/WBE and shall state the DBEVBE quote together with the actual subcontract price <br /> Ipaid and the name of the subcontractor to whom the work was subsequently awarded. <br /> F. List all DBE and WBE subcontractors and suppliers from which bids or quotes for work on this <br /> Iproject have been solicited: <br /> Name of Firm Address Work [TWO!ved <br /> I -?.--i, 1.;) 1-*...cosce,04,4e, <br /> otA.-Vto,st LayILT <br /> Snail)in is h, t,..J A fnc.1)La La_x-OckeLp oki_D <br /> _P o -+`?..04- I 55w NOTilrert V•A %Sala 1-0-41-fisco+LAc <br /> \oc,J3 at, CActili'MA LIZA-Al. ' Q10 V I 1 ' C4ili.I I-C-V l.1-kix_44-e.2.43:PaiAti-Lik Lti pl._ Truckun <br /> I CaS . )1_ ''k 0 <br /> )a-1-, \ -i)-9-...j?2A.,9 LO• MAA 0 4,z0 ;(IP' %a-7'D - :Tug ja,t... <br /> ?wick`I idel 61-(1). Inc, 1N 31-A Aix_f›. 14-4 ux4-41.603.3- -••••oca.c- .... pt ji <br /> I1. Please estimate the percentage of work that will be subcontracted to DBE's and WBE's <br /> subcontractor and/or suppliers: .aezisgEiNGPei 2-. 0(5/o <br /> I 2. Please estimate the percentage of your force on this project that will be made up of <br /> _L <br /> minority group members: 2-f-ro <br /> e_.P.-4/1 L <br /> I I CERTIFY THAT THE ABOVE IS TRUE AND COMPLETE TO THE BEST OF MY <br /> KNOWLEDGE AND BELIEF AND AGREE TO PROVIDE ALL ABOVE INTORMATION <br /> REQUESTED BY THE CITY REGARDING DBE/WBE SUBCONTRACT WORK. <br /> ISignature': <br /> C., 9\ 5.00,....sc,- <br /> IEND OF DOCUMENT 00 45 39 <br /> I <br /> I <br /> Portal 1 Replacement June 2017 <br /> WOfit UP3602 _ <br /> 00 45 <br /> . ._ <br />