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6.D. - Page 87 of 170 <br />Request for Qualifications: <br />General Park Building Construction, Retrofit, Maintenance, and/or Repairs <br />SCHEDULE C <br />MBE/WBE/SBE/EBE/DVBE/OBE UTILIZATION PROFILE <br />Project Title Contract No. <br />Consultant Address <br />Contact Person Phone/Fax <br />CONTRACT AMOUNT THIS INVOICE AMOUNT INVOICED TO DATE AMOUNT <br />(INCLUDING AMENDMENTS) (INCLUDE THIS INVOICE) <br />MBE/WBE/SBE/EBE/DVBE/OBE SUBCONTRACTORS (LIST ALL SUBS) <br />NAME OF <br />SUBCONTRACTOR <br />MBE/WBE/ <br />SBE/EBE/ <br />DVBE/OBE <br />ORIGINAL <br />SUBCONTRACT <br />AMOUNT <br />THIS INVOICE <br />(AMOUNT NOW <br />DUE) <br />INVOICED TO DATE <br />(INCLUDE THIS <br />INVOICE) <br />SCHEDULED <br />PARTICIPATION <br />TO DATE <br />$ <br />/ <br />TOTAL WBE PARTICIPATION <br />$ <br />TOTAL SBE PARTICIPATION <br />$ <br />/ <br />Title: Date: <br />TOTAL EBB PARTICIPATION <br />$ <br />TOTAL DVBE PARTICIPATION <br />$ <br />TOTAL OBE PARTICIPATION <br />$ <br />CURRENT PERCENTAGE OF MBE/WBE/SBE/EBE/DVBE/OBE <br />PARTICIPATION TO DATE <br />Signature of Person Completing this Form: <br />DOLLARS <br />PERCENT <br />Printed Name of Person Completing this Form: <br />TOTAL MBE PARTICIPATION <br />$ <br />/ <br />TOTAL WBE PARTICIPATION <br />$ <br />TOTAL SBE PARTICIPATION <br />$ <br />/ <br />Title: Date: <br />TOTAL EBB PARTICIPATION <br />$ <br />TOTAL DVBE PARTICIPATION <br />$ <br />TOTAL OBE PARTICIPATION <br />$ <br />MUST BE SUBMITTED WITH EACH INVOICE <br />IMPORTANT — RESPONDERS MUST SUBMIT ALL REQUIRED FORMS (COMPLETELY FILLED OUT) BY RFQ <br />SUBMITTAL DEADLINE. <br />Page 81 of 103 <br />170 <br />