McCann Construction Enterprises Inc 11/7/2018

I Instructions for Underutilized Disadvantaged Business Enterprise Utilization Certification Form I Box 1: Name of Bidder(Proposal holder) submitting Bid. Box 2: Name of the Project. Column 1: Name of the Underutilized Disadvantaged Business Enterprise(UDBE). UDBE Firms can be found using the I search tools under the Firm Certification section of the Diversity Management and Compliance System web page httos:/iwsdot.diversitycornoliance.corn Repeat the name of the UDBE for each Project Role that will be performed. Column 2: The Project Role that the UDBE will be performing as follows, I • Prime Contractor • Subcontractor • Subcontractor(Force Account) I • Work sublet as Force Account must be listed separately. • Manufacturer • Regular Dealer • Work sublet to a Regular Dealer must be listed separately. • Regular Dealer status must be approved prior to Bid submittal by the Office of Equal Opportunity, Washington State Department of Transportation, on each Contract. • Broker I • Work sublet to a Broker must be listed separately. List each project role to be performed by a single UDBE individually on a separate row(s). The role is used to determine what portion of the amount to be subcontracted (Column 4) may be applied toward meeting the goal (column 5). I Column 3: Provide a description of the work to be performed by the UDBE.The work to be performed must be consistent with the Certified Business Description of the UDBE provided at the Diversity Management and Compliance System web page httos://wsdot.diversitycompliance.com • A Bidder subletting a portion of a bid item shall state"Partial" and describe the Work that is included. I • For example;"Electrical (Partial)—Trenching". • "Mobilization"will not be accepted as a description of Work. Column 4: List the total amount to be subcontracted to each UDBE for each Project Role they are performing. I Column 5: This is the dollar amount for each line listed in the certification that the prime intends to apply towards meeting the COA Contract goal. It may be that only a portion of the amount subcontracted to a UDBE in Column 4 is eligible to be credited toward meeting the goal See Note 1, Note 2, Note 3.The Contracting Agency will utilize the sum of this column (Box 4)to determine whether or not the bidder has met the goal. In the event of an I arithmetic error in summing column 5 or en error in making appropriate reductions in the amounts in column four, See Note 1, Note 2, Note 3, then the mathematics will be corrected and the total (Box 4)will be revised accordingly. I Note 1: For Work sublet as Force Account the bidder may only claim 50% of the amount subcontracted (Column 4) towards meeting the goal(Column 5). This information will be used to demonstrate that the UDBE contract goal is met at the time that the bidder submits their bid. For example; amount sublet as force account= $100,000 (Column 4)equates to($100,000 X 50%) _ $50,000 (Column 5)to be applied towards the goal. I Note 2: For Work sublet to a Regular Dealer the bidder may only claim 60% of the cost of the materials or supplies (Column 4)towards meeting the goal (Column 5). For example; Material cost= $100,000(Column 4) equates to ($100.000 X 60%)=$60,000 (Column 5)to be applied towards the goal Note 3: For Work sublet to a Broker the bidder may only claim the fees paid to a Broker towards meeting the I goal (Column 4). For example; amount sublet to a broker= $100,000(Column 4) equates to ($100,000 X reasonable fee%) =$(Column 5)to be applied towards the goal. Box 3: Box 3 is the COA Contract goal which is the minimum required UDBE participation. The goal stated in the Contract will be in terms of a dollar amount or a percentage in the Contract. When expressed as a percentage I you must multiply the percentage times the sum total of all bid items as submitted in the Bidder's Proposal to determine the dollar goal and write it in Box 3. In the event of an error in this box,the Contracting Agency will revise the amount accordingly. Box 4: Box 4 is the sum of the values in column 5. This value must equal or exceed the COA Contract goal l amount written in Box 3 or; Box 5. Check Box 5 if insufficient UDBE Participation has been achieved and a good faith effort is required. Refer to the subsection titled. Selection of Successful Bidder/Good Faith Efforts (GFE) in the Contract. See the Disadvantaged Business Enterprise Participation specification in the Contract for more , information. DOT Form 272-056U IRevised 0212018 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal