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EXHIBIT 17-F Local Assistance Procedures Manual <br /> Final RepoM-Utilization of Disadvantaged Business Enterprises(DB�,First-Tier Subcontractors <br /> FINAL REPORT-UTILIZATION OF DISADVANTAGED BUSINESS <br /> ENTERPRISES(DBE),FIRST-TIER SUBCONTRACTORS <br /> c�aao2{�)(xev.oaiaoog� <br /> The form requires specific information regarding the construdion project: Contract Numbex,County,Route,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 contractora are required to <br /> show the date of work perfornted by their own forces along with the conesponding dollar value of work. <br /> The form has a column to enter the Contract Item Na(or Item No's)and description of work performed or materials <br /> provided,as well as a column for the subcontractor name and busmess address.For those fums who are DBE,there is a <br /> column to enter their DBE Certification Number.The DBE should provide their cert�cation 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 fonn has s�columns for the dollar value to be entered for the item work performed by the xubcontractor. <br /> The Non-DBE column is used to enter the dollaz value of work perfrnmed for fums who are not certified <br /> DBE. <br /> The decision of which column 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,ownerahip,and conirol issues at time of certification.To confum the ceitification status <br /> and program status,access the Department of Transportation Civil Rights web site at: <br /> http://www.dot.ca. o�v_!hq/bev or by callmg(916)3241700 or the toll 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 am Status Column to be used <br /> ff o am status shows DBE onl with no other o listed DBE <br /> If a contractor performiitg work as a DBE on the project beoomes decertified and still performs work af�er their <br /> decertification date,enter the total dollar value perfotrned by this contractor under the appropriate DBE identification <br /> column. <br /> If a contractor perfornung work as a non-DBE on the project becomes certified as a DBE,enter the dollar value of all <br /> work perfonned after certification as a DBE under the appropriate identif'ication column. <br /> Enter the total of each of the six columns in Form CEM-2402(F). <br /> Any changes to DBE certification must also be submitted on Form-CEM 2403(F). <br /> Enter the Date Work Completed as well as the Date of Final Payment(the date when the prime contractor made the <br /> `�nal paymenY'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�-� <br /> REV:09-26-13 VR <br /> ATTY/AGR/2013.169/BELLECCI&ASSOCIATES Page 36 of 38 <br /> CHARTER ST.SRTS <br />