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EXHIBIT 17-F Local Assistance Procedures Manual <br /> Final Report-Utilization of Disadvantaged Business Enterprises(DBE),First-Tier Subcontractors <br /> 7.1.C. - Page 38 <br /> FINAL REPORT—UTILIZATION OF DISAD�ANTAGED BUSINESS <br /> ENTERPRISES(DBE),FIRST-TIER SUBCONTRACTORS <br /> cEM z4oz�)(Re�. oz�zoos� <br /> The form requires specific information regarding the construction project: Contract Number,County,Aoute,Post <br /> Miles,Federal-aid Project No.,the Administering Agency,the Contract Completion Date and the Estimated Contract <br /> Amount.It requires the prime contractor name and business address.The focus of the form is to describe who did what <br /> by contract item number and descriptions,asking for specific dollar values of item work completed broken down by <br /> subcontractors who performed the work both DBE and non-DBE work forces.DBE prime contractars are required to <br /> show the date of work performed by their own forces along with the corresponding dollar value of work. <br /> The form has a column to enter the Contract Item No. (or Item No's) and description of work performed or materials <br /> provided,as we11 as a coluxnn for the subcontractor name and business address.Far those firms who are DBE,there is a <br /> column to enter their DBE Certification Number.The DBE should provide their certification number to the contractor and <br /> notify the contractor in writing with the date of the decertification if their status should change during the course of the <br /> project <br /> The form has six columns for the dollar value to be entered for the item work performed by the subcontractor. <br /> The Non-DSE column is used to enter the dollar value of work performed for firms who are not certified <br /> DBE. <br /> The decision of which coluxnn to be used for entering the DBE dollar value is based on what program(s) <br /> status the firm is certified.This program status is determined by the California Unified Certification Program <br /> by ethnicity,gender,ownership,and control issues at time of certification.To confirm the certification status <br /> and program status,access the Department of Transportation Civil Rights web site at: <br /> http:llwww.dot.ca.�ovlhqlbe�or by calling(916)324-1700 or the to11 free number at(888) 810-6346. <br /> Based on this DBE Program status,the following table depicts which column to be used: <br /> DBE Pro ram Status Column to be used <br /> If ro am status shows DBE onl with no other ro ams listed DBE <br /> If a contractor performing work as a DBE on the project becomes decerti�ed and sti11 performs work after their <br /> decertification date,enter the total dollar value performed by this contractor under the appropriate DBE identification <br /> column. <br /> If a contractor performing work as a non-DBE on the proj ect becomes certif'ied as a DBE,enter the dollar value of a11 <br /> work performed after certification as a DBE under the appropriate identification column. <br /> Enter the total of each of the six coluxnns in Form CEM-2402(F). <br /> Any changes to DBE certification must also be submitted on Form-CEM 2403(F). <br /> Enter the Date Wark Completed as well as the Date of Final Payment(the date when the prime contractor made tlie <br /> "final payment"to the subcontractor for the portion of work listed as being completed). <br /> The contractor and the resident engineer sign and date the form indicating that the information provided is complete and <br /> correct. <br /> Page 17-22 <br /> July 1,2012 LPP 09-02 <br /> REV:09-26-13 VR <br /> Page 36 of 38 <br />