| A | B | C | D | E | F | G | H | I | J | |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Colorado Department of Transportation | |||||||||
| 2 | Anticipated DBE Participation Plan (CDOT Form 1414) | |||||||||
| 3 | Section A. Bidder and DBE Information. This section must be completed by the Bidder. | |||||||||
| 4 | 1. Project S/A No. or PCN Number (5 digit #): | 2. FHWA Project # or Subaward Agreement # from COTRAMS (FTA projects): | 3. Project Name: | |||||||
| 5 | 4. Name of Bidder: | 5. Bidder's Contact Name: | 6. Bidder's Contact Phone #: | |||||||
| 6 | 7. Bidder's Contact Email Address: | 8. Bid Submission Date: | 9. Region: | |||||||
| 7 | 10. DBE Contract Goal: | |||||||||
| 8 | Section B. DBE Commitments | |||||||||
| 9 | 9. DBE Commitment Details | |||||||||
| 10 | DBE Firm Name | Work to be Performed | Commitment Amount | Eligible Participation | ||||||
| 20 | Total Eligible Participation: | $0.00 | ||||||||
| 21 | Total Bid Amount: | |||||||||
| 22 | Total Eligible Participation Percentage: | #DIV/0! | ||||||||
| 23 | Section C. Bidder Signature | |||||||||
| 24 | 10. Bidder Representative: | |||||||||
| 25 | COMMITMENTS LISTED ON THIS FORM SHALL BE BINDING ON THE BIDDER
UPON CONTRACT AWARD. IF THE DBE GOAL IS ZERO, DBE COMMITMENTS
ARE OPTIONAL AND THE BIDDER IS NOT REQUIRED TO LIST ANY DBE COMMITMENTS
ON THIS FORM. This section must be signed by an individual with the authority to contractually bind the Bidder. By signing this form, as an
authorized representative of the Bidder, you declare under penalty
of perjury in the second degree and any other applicable state
or federal laws that the statements made in this document are
true and complete to the best of your knowledge. Further, you
attest that you understand the following: CDOT shall not award a contract (or provide its concurrence to award a Local Agency Project) until it has been determined that commitments are sufficient to meet the DBE contract goal or else good faith efforts have been made to meet the goal despite falling short. Once your bid has been submitted, commitments may not be modified or terminated without the approval of CDOT. If selected as the low apparent bidder, you shall submit a CDOT Form 1415 for each commitment listed above. If you have not met the contract goal, you will also be required to submit documentation of all good faith efforts to meet the contract goal. It is your responsibility to ensure that the selected DBEs are certified for the work to be performed and that their eligible participation has been properly counted. Please review your project's DBE requirements for additional information and instructions on calculating eligible participation. |
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| 26 | a. Name | b. Title | c. Signature | d. Date | ||||||
| 28 | "Previous editions are obsolete and may not be used." CDOT Form No. 1414 [06/24] Page 1 | |||||||||