R-10-07-22-10A1 - 7/22/2010RESOLUTION NO. R -10-07-22-10A1
WHEREAS, the City of Round Rock ("City") has received funding from the Federal Transit
Administration, and
WHEREAS, in accordance with regulations of the U.S. Department of Transportation, 49 CFR
Part 26, the City is required to establish and maintain a Disadvantaged Business Enterprise (DBE)
Program, and
WHEREAS, the "Fiscal Year 2011 Disadvantaged Business Enterprise (DBE) Program" has
been presented for consideration and adoption by the City Council, Now Therefore
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS,
That the "Fiscal Year 2011 Disadvantaged Business Enterprise (DBE) Program", which is
attached hereto as Exhibit "A", is hereby approved and adopted.
The City Council hereby finds and declares that written notice of the date, hour, place and
subject of the meeting at which this Resolution was adopted was posted and that such meeting was open
to the public as required by law at all times during which this Resolution and the subject matter hereof
were discussed, considered and formally acted upon, all as required by the Open Meetings Act, Chapter
551, Texas Government Code, as amended.
RESOLVED this 22nd day of July, 2010.
ALAN MCGRAW, Mayor
City of Round Rock, Texas
ATTEST:
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SARA L. WHITE, City Secretary
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ROUND ROCK, TEXAS
PURPOSE. PASSION. PROSPERITY.
Fiscal Year 2011
Disadvantaged Business Enterprise
Program
July 2010
EXHIBIT
„A„
TABLE OF CONTENTS
Page Number
Policy Statement 3
General Requirements 5
Administrative Requirements 9
Goals, Good Faith Efforts, and Counting 13
Certification 17
Compliance and Enforcement 19
Attachments
Attachment 1 — Organizational Chart 21
Attachment 2 — DBE Directory 25
Attachment 3 — Monitoring and Enforcement Mechanisms 29
Attachment 4 — Overall Goal Calculations 33
Attachment 5 — Breakout of Estimated Race -Neutral & Race -Conscious 41
Participation
Attachment 6 — Forms for Demonstration of Good Faith Efforts 45
Attachment 7 — Regulation: 49 Code of Federal Regulations (CFR) Part 26 49
Attachment 8 — Texas Unified Certification DBE Program Instructions and 53
Application
Figures
Figure 1 — Organizational Chart
23
Forms
Form 1 — Disadvantaged Business Enterprise (DBE) Utilization 47
Form 2 — Letter of Intent 48
Form 3 — Texas Unified Certification Program Disadvantaged Business 55
Enterprise Instructions and Application
POLICY STATEMENT
Objectives/Policy Statement (49 CFR Section 26.1 and 26.23)
The City of Round Rock has established a Disadvantaged Business Enterprise (DBE)
program in accordance with regulations of the U.S. Department of Transportation (DOT),
49 CFR Part 26. The City of Round Rock has received Federal financial assistance from
the Department of Transportation, and as a condition of receiving this assistance, the
City of Round Rock has signed an assurance that it will comply with 49 CFR Part 26.
It is the policy of the City of Round Rock to ensure that DBEs, as defined in 49 CFR Part
26, have an equal opportunity to receive and participate in DOT—assisted contracts. It is
also our policy:
1. To ensure non-discrimination in the award and administration of DOT —
assisted contracts;
2. To create a level playing field on which DBEs can compete fairly for DOT -
assisted contracts;
3. To ensure that the DBE Program is narrowly tailored in accordance with
applicable law;
4. To ensure that only firms that fully meet 49 CFR Part 26 eligibility standards
are permitted to participate as DBEs; and
5. To help remove barriers to the participation of DBEs in DOT assisted
contracts, as allowed by federal, state and local regulations.
6. To assist the development of firms that can compete successfully in the
market place outside the DBE Program.
The City of Round Rock has designated the following individual as our DBE Liaison
Officer: David E. Bartels, 2008 Enterprise Dr., Round Rock, Texas 78664; (512) 671-
2760; dbartelsa.round-rock.tx.us. In that capacity, Mr. Bartels is responsible for
implementing all aspects of the DBE program. Implementation of the DBE program is
accorded the same priority as compliance with all other legal obligations incurred by the
City of Round Rock in its financial assistance agreements with the Department of
Transportation.
The City of Round Rock has disseminated this policy statement to the City Council and
all of the components of our organization. We have distributed this statement to DBE
and non -DBE business communities that perform work for us on DOT -assisted
contracts. This statement is included in all solicitation packages and has been
communicated to local business groups, chambers and community organizations.
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GENERAL REQUIREMENTS
Objectives (49 CFR Section 26.1)
The objectives are found in the policy statement on the first page of this program.
Applicability (49 CFR Section 26.3)
The City of Round Rock is the recipient of federal transit funds authorized by Titles I
(Highways), III (Public Transportation) and V (Research), of Safe, Accountable, Flexible
and Efficient Transportation Equity Act — Legacy for Users of 2003 (SAFTEA-LU), Pub.
L. 109-59.
Definitions (49 CFR Section 26.5)
The terms used in this program have the meanings defined in 49 CFR Section 26.5.
Non-discrimination Requirements (49 CFR Section 26.7)
The City of Round Rock will never exclude any person from participation in, deny any
person the benefits of, or otherwise discriminate against anyone in connection with the
award and performance of any contract covered by 49 CFR Part 26 on the basis of race,
color, sex, or national origin.
In administering its DBE program, the City of Round Rock will not, directly or through
contractual or other arrangements, use criteria or methods of administration that have
the effect of defeating or substantially impairing accomplishment of the objectives of the
DBE program with respect to individuals of a particular race, color, sex, or national
origin.
Record Keeping Requirements (49 CFR Section 26.11)
Reporting to U.S. Department of Transportation: 49 CFR 26.11(b)
The City of Round Rock will report DBE participation on a semi-annual basis, using the
Uniform Report of DBE Awards or Commitments and Payments Form, which was
approved on June 16, 2003. These reports will reflect payments actually made to DBEs
on DOT -assisted contracts.
Bidders List: 49 CFR 26.11(c)
The City of Round Rock will create a bidders list, consisting of information about all DBE
and non -DBE firms that bid or quote on DOT -assisted contracts. The purpose of this
requirement is to allow use of the bidders list approach to calculating overall goals. The
bidder list will include the name, address, DBE or non -DBE status, age, and annual
gross receipts of firms.
The City will collect this information in the following ways:
The City will use the information obtained from the bid proposals.
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The City will require prime bidders to report the names, addresses, DBE
or non -DBE status, age, and annual gross receipts of firms of all firms
who quote to them on subcontracts.
The City will monitor payments to DBEs.
The City will require prime contractors to maintain records and documents
of payments to DBEs for three (3) years following the performance of the
contract. These records will be made available for inspection upon
request by any authorized representative of the City or DOT. This
reporting requirement also extends to any certified DBE subcontractor.
The City may perform interim audits of contract payments to DBEs. The
audit will review payments to DBE subcontractors to ensure that the
actual amount paid to DBE subcontractors equals or exceeds the dollar
amounts stated in the schedule of DBE participation.
Federal Financial Assistance Agreement (49 CFR Section 26.13)
The City of Round Rock has signed the following assurances, applicable to all DOT -
assisted contracts and their administration:
Assurance: 49 CFR 26.13(a)
The City of Round Rock shall not discriminate on the basis of race, color,
national origin, or sex in the award and performance of any DOT assisted
contract or in the administration of its DBE Program or the requirements
of 49 CFR Part 26. The recipient shall take all necessary and reasonable
steps under 49 CFR Part 26 to ensure nondiscrimination in the award and
administration of DOT assisted contracts. The recipient's DBE Program,
as required by 49 CFR Part 26 and as approved by DOT, is incorporated
by reference in this agreement. Implementation of this program is a legal
obligation and failure to carry out its terms shall be treated as a violation
of this agreement. Upon notification to the City of its failure to carry out
its approved program, the Department may impose sanction as provided
for under part 26 and may, in appropriate cases, refer the matter for
enforcement under 18 U.S.C. 1001 and/or the Program Fraud Civil
Remedies Act of 1986 (31 U.S.C. 3801 et seq.).
Contract Assurance: 49 CFR 26.13b
The City of Round Rock will ensure that the following clause is placed in every DOT -
assisted contract and subcontract:
The contractor, sub -recipient, or subcontractor shall not discriminate on the basis
of race, color, national origin, or sex in the performance of this contract. The
contractor shall carry out applicable requirements of 49 CFR Part 26 in the award
and administration of DOT assisted contracts. Failure by the contractor to carry
out these requirements is a material breach of this contract, which may result in
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the termination of this contract or such other remedy as the recipient deems
appropriate.
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ADMINISTRATIVE REQUIREMENTS
DBE Program Updates (49 CFR Section 26.21)
Since the City of Round Rock has received grants of approximately $3,000,000 and pre-
award authority of $ 7,169,642, the City will continue to carry out this program until all
funds from DOT financial assistance have been expended. The City will provide to DOT
updates representing significant changes in the program.
Policy Statement (49 CFR Section 26.23)
The Policy Statement is elaborated on the first page of this program.
DBE Liaison Officer (49 CFR Section 26.25)
The City of Round Rock has designated the following individual as the DBE Liaison
Officer (DBELO):
David Bartels
Administrator
Public Works Planning and Programs
City of Round Rock
2008 Enterprise Drive
Round Rock, Texas 78664
Phone: (512) 671-2760
Fax: (512) 218-5563
E-mail: dbartelsaround-rock.tx.us
In that capacity, the DBELO is responsible for implementing all aspects of the DBE
program and ensuring that the City of Round Rock complies with all provisions of 49
CFR Part 26. The DBELO has direct, independent access to the City Manager
concerning DBE program matters. An organization chart displaying the DBELO's
position in the organization is found in Attachment 1, Organizational Chart, to this
program.
The DBELO is responsible for developing, implementing and monitoring the DBE
program, in coordination with other appropriate officials. The DBELO has a staff of one
(1) to assist in the administration of the program. The duties and responsibilities of the
DBELO and staff include the following:
1. Gathers and reports statistical data and other information as required by
DOT.
2. Reviews third party contracts and purchase requisitions for compliance with
this program.
3. Works with all departments to set overall annual goals.
4. Ensures that bid notices and requests for proposals are available to DBEs in
a timely manner.
5. Identifies contracts and procurements so that DBE goals are included in
solicitations (both race -neutral methods and contract specific goals
attainment) and identifies ways to improve progress.
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6. Analyzes the City of Round Rock's progress toward attainment and identifies
ways to improve progress.
7. Participates in pre-bid and pre -construction meetings.
8. Advises the City Manager/City Council on DBE matters and achievement.
9. Responsible for determining whether a bidder/offeror who has not met the
contract goal has documented sufficient good faith efforts.
10. Provides DBEs with information and assistance in preparing bids, obtaining
bonding and insurance.
11. Plans and participates in DBE training seminars.
12. Acts as liaison to the Uniform Certification Process in the State of Texas.
13. Provides outreach to DBEs and community organizations to advise them of
opportunities.
14. Maintains the bidders list of all DBE and non -DBE firms that bid or quote on
DOT -assisted contracts and matching fund contracts.
DBE Financial Institutions (49 CFR Section 26.27)
It is the policy of the City of Round Rock to investigate the full extent of services offered
by financial institutions owned and controlled by socially and economically
disadvantaged individuals in the community, to make reasonable efforts to use these
institutions, and to encourage prime contractors on DOT -assisted contract to make use
of these institutions. The City has researched the availability of DBE owned financial
institutions at http://www.federalreserve.gov/releases/mob and based on the December
31, 2009 quarterly data, the City found services offered by the following financial
institutions, although the institutions are not owned and controlled by socially and
economically disadvantaged individuals in the community.
1. Southwestern NB, Austin Branch, Austin, Texas
2. United Central Bank, Austin Branch, Austin, Texas
3. International Bank of CMRC, Austin, Texas
4. Falcon International Bank, Buda Branch, Buda, Texas
Prompt Payment Mechanisms (49 CFR Section 26.29)
The City of Round Rock will include the following clauses in each DOT -assisted prime
contract:
Prompt Payment Act: In accordance with Chapter 2251, V.T.C.A., Texas
Government Code, any payment to be made by the City to the Vendor will be
made within thirty (30) days of the date the City receives goods under this
Agreement, the date the performance of the services under this Agreement are
completed, or the date the City receives a correct invoice for the goods or
services, whichever is later. The Vendor may charge interest on an overdue
payment at the "rate in effect" on September 1 of the fiscal year in which the
payment becomes overdue, in accordance with V.T.C.A., Texas Government
Code, Section 2251.025(b). This Prompt Payment Policy does not apply to
payments made by the City in the event:
1. There is a bona fide dispute between the City and the Vendor, a
contractor, subcontractor, or supplier about the goods delivered or the
service performed that causes the payment to be late; or
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2. There is a bona fide dispute between the Vendor and a subcontractor
or between a subcontractor and its supplier about the goods delivered
or the service performed that causes the payment to be late; or
3. The terms of a federal contract, grant, regulation, or statute prevent
the City from making a timely payment with federal funds; or
4. The invoice is not mailed to the City in strict accordance with any
instruction on the purchase order relating to the payment.
Payment to Subcontractors; Retainage: The prime contractor agrees to pay
each subcontractor under this prime contract for satisfactory performance of its
contract no later than thirty (30) days from the receipt of each payment the prime
contractor receives from the City of Round Rock. The prime contractor agrees
further to return retainage payments to each subcontractor within thirty (30) days
after the subcontractor's work is satisfactorily completed. Any delay or
postponement of payment from the timeframe stated in this paragraph may occur
only for good cause, as determined by the City, and following written approval of
the City. This clause applies to both DBE and non -DBE subcontractors and shall
be included in the contract between the prime contractor and any and all
subcontractors.
If the prime contractor does not pay a subcontractor promptly as defined in the
preceding paragraph, the City shall hold retainage from the prime contractor and
provide for prompt and regular incremental acceptances of portions of the prime
contract, pay retainage to the prime contractor based on these acceptances, and
require a contract clause obligating the prime contractor to pay all retainage
owed to the subcontractor for satisfactory completion of the accepted work within
thirty (30) days after payment to the prime contractor.
Dispute Resolution: If a dispute or claim arises under this Agreement, the
parties agree to first try to resolve the dispute or claim by appropriate internal
means, including referral to each party's senior management. If the parties
cannot reach a mutually satisfactory resolution, then and in that event any such
dispute or claim may be sought to be resolved with the help of a mutually -
selected mediator. If the parties cannot agree on a mediator, the City and the
prime contractor, or the prime contractor and a subcontractor, shall each select a
mediator and the two mediators shall agree upon a third mediator. Any costs
and fees associated with the mediation, other than attorneys fees, shall be
shared equally by the parties. This clause applies to both DBE and non -DBE
subcontractors and shall be included in the contract between the prime
contractor and any and all subcontractors.
All parties hereby expressly agree that no claim or dispute between the parties
arising out of or relating to this agreement or a breach hereof shall be decided by
any arbitration proceeding, including without limitation any proceeding under the
Federal Arbitration Act (9 USC Section 1-14) or any applicable state arbitration
statute. This clause applies to both DBE and non -DBE subcontractors and shall
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be included in the contract between the prime contractor and any and all
subcontractors.
Directory (49 CFR Section 26.31)
The City of Round Rock participates in a combined statewide directory as part of the
Texas Uniform Certification Program (TUCP). The combined directory is available from
the Texas Department of Transportation at
http://www.dot.state.tx.us/business/tucpinfo.htm.
The City also provides the directory in hard copy upon request.
Overconcentration (49 CFR Section 26.33)
Based on the research performed for calculating the overall goal, the City of Round Rock
has not identified that overconcentration exists in the types of work that DBEs perform.
Business Development Programs (49 CFR Section 26.35)
The City of Round Rock has not established a business development program.
Monitoring and Enforcement Mechanisms (49 CFR Section 26.37)
The City of Round Rock will take the following monitoring and enforcement mechanisms
to ensure compliance with 49 CFR Part 26.
1. The City will bring to the attention of the Department of Transportation any false,
fraudulent, or dishonest conduct in connection with the program, so that DOT can
take the steps (e.g., referral to the Department of Justice for criminal prosecution,
referral to the DOT Inspector General, action under suspension and debarment or
Program Fraud and Civil Penalties rules) provided in 26.109.
2. The City will consider similar action under the City's own legal authority, including
responsibility determinations in future contracts. Attachment 3, Monitoring and
Enforcement Mechanisms, lists the regulation, provisions, and contract remedies
available to the City in the events of non-compliance with the DBE regulation by a
participant in the City's procurement activities.
3. The City will also provide a monitoring and enforcement mechanism to verify that
work committed to DBEs at contract award is actually performed by the DBEs. This
will be accomplished by auditing the DBE contractor or subcontractor to verify that
the firm is performing a commercially useful function that may include: performing,
managing and supervising the work; negotiating price, determining quality and
quantity, ordering, installing and paying for material and supplies; evaluating the
amount of work subcontracted, industry practices, whether the amount the firm is to
be paid under the contract or subcontract is commensurate with the work actually
performed and the DBE credit claimed for its performance of the work; and other
relevant factors.
4. The City will keep a running tally of actual payments to DBE firms for work committed
to them at the time of contract award.
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GOALS, GOOD FAITH EFFORTS, AND COUNTING
Set -asides or Quotas (49 CFR Section 26.43)
The City of Round Rock does not use quotas in any way in the administration of this
DBE program.
Overall Goals (49 CFR Section 26.45)
A description of the methodology to calculate the overall goal and the goal calculations
can be found in Attachment 4, Overall Goal Calculation, to this program. This
attachment of the program will be updated annually.
In accordance with 49 CFR Section 26.45(f) the City of Round Rock will submit its
overall goal to the U.S. Department of Transportation (DOT)/Federal Transit
Administration (FTA) on August 1st of each year. Before establishing the overall goal
each year, the City of Round Rock will consult with elected and appointed City and
County officials, local chambers of commerce, minority, women's and general contractor
groups, community organizations, and other officials and organizations, to obtain
information concerning the availability of disadvantaged and non -disadvantaged
businesses and to discuss the effects of discrimination on opportunities for DBEs, and
the City's efforts to establish a level playing field for the participation of DBEs.
Following this consultation, the City will publish a notice of the proposed overall goals,
informing the public that the proposed goal and its rationale are available for inspection
during normal business hours at the City's principal office for 30 days following the date
of the notice, and informing the public that the City and DOT/FTA will accept comments
on the goals for 45 days from the date of the notice. The City will publish the notice in
local newspapers, available minority -focus media, trade publications and the City's,
website. Normally, the City will issue this notice by June 1st of each year. The notice will
include addresses to which comments may be sent and addresses (including offices and
websites) where the proposal may be reviewed.
The City's overall goal submission to the DOT/FTA will include a summary of information
and comments received during this public participation process and the City's
responses.
The City will begin using the overall goal on October 1st of each year, unless the City has
received other instructions from DOT/FTA. If the City establishes a goal on a project
basis, the City will begin using the goal by the time of the first solicitation for a DOT -
assisted contract for the project.
Transit Vehicle Manufacturers Goals (49 CFR Section 26.49)
The City of Round Rock will require each transit vehicle manufacturer, as a condition of
being authorized to bid or propose on FTA -assisted transit vehicle procurements, to
certify that it has complied with the requirements of this section. Alternatively, The City
may, at its discretion and with FTA approval, establish project -specific goals for DBE
participation in the procurement of transit vehicles in lieu of the TVM complying with this
element of the program.
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Breakout of Estimated Race -Neutral & Race -Conscious Participation
(49 CFR Section 26.51(a -c))
The breakout of estimated race -neutral and race -conscious participation can be found in
Attachment 5, Breakout of Estimated Race -Neutral & Race -Conscious Participation, to
this program. This section of the program will be updated annually when the goal
calculation is updated.
Contract Goals (49 CFR Section 26.51(d -g))
The City of Round Rock will use contract goals to meet any portion of the overall goal
that the City does not project being able to meet using race -neutral means. Contract
goals are established so that, over the period to which the overall goal applies, they will
cumulatively result in meeting any portion of the City's overall goal that is not projected
to be met through the use of race -neutral means.
The City will establish contract goals only on those DOT -assisted contracts that have
subcontracting possibilities. The City need not establish a contract goal on every such
contract, and the size of contract goals will be adapted to the circumstances of each
such contract (e.g., type and location of work, availability of DBEs to perform the
particular type of work.)
The City will express the contract goals as a percentage of the Federal share of a DOT -
assisted contract.
Good Faith Efforts Procedures (Section 26.53)
Demonstration of good faith efforts (26.53(a) & (c))
The obligation of the bidder/offeror is to make good faith efforts to include DBEs in the
project. The bidder/offeror can demonstrate that it has done so either by meeting the
contract goal or documenting good faith efforts. Examples of good faith efforts are found
in Attachment A to Part 26.
The DBELO is responsible for determining whether a bidder/offeror who has not met the
contract goal has documented sufficient good faith efforts to be regarded as responsive.
The DBELO will ensure that all information is complete and accurate and adequately
documents the bidder/offeror's good faith efforts before the City commits to the
performance of the contract by the bidder/offeror.
Information to be submitted (26.53(b))
The City of Round Rock treats bidder/offers' compliance with good faith efforts'
requirements as a matter of responsiveness.
Each solicitation for which a contract goal has been established will require the
bidders/offerors to submit the following information:
1. The names and addresses of DBE firms that will participate in the contract;
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2. A description of the work that each DBE will perform;
3. The dollar amount of the participation of each DBE firm participating;
4. Written and signed documentation of commitment to use a DBE
subcontractor whose participation it submits to meet a contract goal
(Attachment 6, Form 1);
5. Written and signed confirmation from the DBE that it is participating in the
contract as provided in the prime contractors commitment (Attachment 6,
Form 2); and
6. If the contract goal is not met, evidence of good faith efforts.
Administrative reconsideration (26.53(d))
A bidder/offeror may request administrative reconsideration within fifteen (15) calendar
days of being informed by the City of Round Rock that it is not responsive due to not
documenting sufficient good faith effort. Bidder/offerors should make this request in
writing to the following reconsideration official: Jerry Galloway, City of Round Rock, 221
East Main Street, Round Rock, Texas, 78664, (512) 218-5432, jdground-rock.tx.us.
The reconsideration official will not have played any role in the original determination
that the bidder/offeror did not document sufficient good faith efforts.
As part of this reconsideration, the bidder/offeror will have the opportunity to provide
written documentation or argument concerning the issue of whether it met the goal or
made adequate good faith efforts to do so. The bidder/offeror will have the opportunity
to meet in person with the City's reconsideration official to discuss the issue of whether it
met the goal or made adequate good faith efforts to do. The City will send the
bidder/offeror a written decision on reconsideration, explaining the basis for finding that
the bidder did or did not meet the goal or make adequate good faith efforts to do so.
The result of the reconsideration process is not administratively appealable to the
Department of Transportation.
Good Faith Efforts when a DBE is replaced on a contract (26.53(f))
The City will require a contractor to make good faith efforts to replace a DBE that is
terminated or has otherwise failed to complete its work on a contract with another
certified DBE, to the extent needed to meet the contract goal. The City will require the
prime contractor to notify the DBELO immediately of the DBE's inability or unwillingness
to perform and provide reasonable documentation.
In this situation, the City will require the prime contractor to obtain the City's prior
approval of the substitute DBE and to provide copies of new or amended subcontracts,
or documentation of good faith efforts.
If the contractor fails or refuses to comply in the time specified, the City will issue an
order stopping all or part of payment/work until satisfactory action has been taken. If the.
contractor still fails to comply, the City may issue a termination for default proceeding.
Bid Specification:
The requirements of 49 CFR Part 26, Regulations of the U.S. Department of
Transportation, apply to this contract. It is the policy of the City of Round Rock to
practice nondiscrimination based on race, color, sex, or national origin in the
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award or performance of this contract. All firms qualifying under this solicitation
are encouraged to submit bids/proposals. Award of this contract will be
conditioned upon satisfying the requirements of this bid specification. These
requirements apply to all bidders/offerors, including those who qualify as a DBE.
A DBE contract goal of 22 percent has been established for this contract. The
bidder/offeror shall make good faith efforts, as defined in Attachment A, 49 CFR
Part 26 (Attachment 1), to meet the contract goal for DBE participation in the
performance of this contract.
The bidder/offeror will be required to submit the following information on the City
specified forms, as provided in the project manual: (1) the names and addresses
of DBE firms that will participate in the contract; (2) a description of the work that
each DBE firm will perform; (3) the dollar amount of the participation of each DBE
firm participating; (4) Written documentation of the bidder/offeror's commitment to
use a DBE subcontractor whose participation it submits to meet the contract
goal; (5) Written confirmation from the DBE that it is participating in the contract
as provided in the commitment made under (4); and (5) if the contract goal is not
met, evidence of good faith efforts.
Counting DBE Participation (Section 26.55)
The City of Round Rock will count DBE participation toward overall and contract goals
as provided in 49 CFR 26.55.
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CERTIFICATION
The Texas Unified Certification Program (TUCP) is a one-stop certification process for
the Texas DBE Program that was established on October 1, 2002. The TUCP follows
Federal Regulation 49 CFR, Part 26. Under the TUCP, the City of Round Rock is a
participant and not a certifying agency. The City's signed agreement was submitted to
the Texas Department of Transportation on April 26, 2006 with an effective date of
March 6, 2006. The City of Austin, through the South Central Texas Regional
Certification Agency (SCTRCA), is the current certifying agency for Williamson County.
All certification activities should be submitted to the certifying entity that services the
Texas County in which the business' home or corporate headquarters is located. The
appropriate addresses are listed below:
The counties of Bastrop, Caldwell, Hays, Travis, and Williamson.
City of Austin, Department of Small and Minority Business Resources
4100 Ed Bluestein
P.O. Box 1088
Austin, TX 78767-2516
Tel: (512) 974-7603
Fax: (512) 974-7601
Email: mail@ci.austin.tx.us
The counties of Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery,
and Waller.
City of Houston Affirmative Action
611 Walker, 7th Floor
Houston, Texas 77002
Tel: (713) 837-9018
Fax: (713) 837-9055
Email: mail(a�citvofhouston.net
The counties of Aransas, Bee, Goliad, Jim Wells, Karnes, Kleberg, Live Oak, Nueces,
Refugio, and San Patricio.
Corpus Christi Regional Transportation Authority
5658 Bear Lane
Corpus Christi, TX 78405
Tel: (361) 289-2712
Fax: (361) 289-0605
Email: mail(a�ccrta.orq
The counties of Collin, Dallas, Denton, Ellis, Erath, Hood, Jack, Johnson, Kaufman,
Navarro, Palo Pinto, Parker, Rockwall, Somervell, Tarrant, and Wise.
North Central Texas Regional Certification Agency
624 Six Flags Drive, Suite 216
Arlington, TX 76011
Tel: (817) 640-0606
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Fax: (817) 640-6315
Email: mailanctrca.orq
The counties of Atascosa, Bandera, Bexar, Comal, Frio, Guadalupe, Kendall, Kerr,
McMullen, Medina, Uvalde, and Wilson.
South Central Texas Regional Certification Agency
305 East Euclid, Ste. 102
San Antonio, TX 78212
Tel: (210) 227-4722
Fax: (210) 227-5712
Email: info@sctrca.org
ALL other remaining counties in Texas.
Texas Department of Transportation
Business Opportunity Programs Section
125 E. 11th Street
Austin, TX 78701-2483
Tel: (866) 480-2518
Fax: (512) 486-5539
Email: tucodata( dot.state.tx.us
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COMPLIANCE AND ENFORCEMENT
Information, Confidentiality, Cooperation (Section 26.109)
The City of Round Rock will safeguard from disclosure to third parties information that
may reasonably be regarded as confidential business information, consistent with
federal, state, and local law.
The City requires all contracting parties to expressly acknowledge that the City is a
Texas municipality and, as such, is subject to and will obey the Texas Public Information
Act and other related statutes.
Section 552.128(a) of the Texas Public Information Act states, "Information submitted by
a potential vendor or contractor to a governmental body in connection with an application
for certification as a historically underutilized or disadvantaged business under a local,
state, or federal certification program is excepted from [required public disclosure],
except as provided by this section."
Revised language in 49 CFR Part 26 Section 26.67 (a) (2) (iii) states that statements of
personal net worth, with supporting documentation, must be kept confidential. "It may be
provided to a third party only with the written consent of the individual to whom the
information pertains. This provision is specifically intended to pre-empt any contrary
application of state or local law." The only exception to this rule relates to applicant
appeals to DOT for a Recipient's denial of certification based on a lack of economic
disadvantage.
Notwithstanding any contrary provisions of state or local law, the City will not release
personal financial information submitted in response to the personal net worth
requirement to a third party (other than DOT) without the written consent of the
submitter.
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Attachment 1
Organizational Chart
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Ilm
City
Manager
Chief
Public Works
Operations
1
DBE
Liaison Officer
Figure 1: Organizational Chart
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Chief
Financial Officer
Director
Finance
Reconsideration
Official
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Attachment 2
DBE Directory
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The most current copy of the Texas Unified Certification Program DBE Information
Directory can be obtained on the world-wide web at
http://www.dot.state.tx.us/business/tucpinfo.htm or a copy can be requested from the
City of Round Rock DBE Liaison Officer, David E. Bartels, 2008 Enterprise Dr., Round
Rock, Texas 78664, (512) 617-2760, dbartels@round-rock.tx.us.
The Texas Unified Certification Program DBE Information Directory is hereby
incorporated by reference.
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Attachment 3
Monitoring and Enforcement Mechanisms
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The City of Round Rock has available several remedies to enforce the DBE
requirements contained in its contracts, including, but not limited to, the following:
1. Breach of contract action, pursuant to the terms of the contract;
2. Breach of contract action, pursuant to State Code and other applicable laws,
statutes, regulations, etc.
In addition, the federal government has available several enforcement mechanisms that
it may apply to firms participating in the DBE program, including, but not limited to, the
following:
1. If you are a firm that does not meet the eligibility criteria of subpart D of this
part and that attempts to participate in a DOT -assisted program as a DBE on
the basis of false, fraudulent, or deceitful statements or representations or
under circumstances indicating a serious lack of business integrity or
honesty, the Department may initiate suspension or debarment proceedings
against you under 49 CFR part 29.
2. If you are a firm that, in order to meet DBE contract goals or other DBE
program requirements, uses or attempts to use, on the basis of false,
fraudulent or deceitful statements or representations or under circumstances
indicating a serious lack of business integrity or honesty, another firm that
does not meet the eligibility criteria of subpart D of this part, the Department
may initiate suspension or debarment proceedings against you under 49 CFR
part 29.
3. In a suspension or debarment proceeding brought under paragraph 1 or 2 of
this section, the concerned operating administration may consider the fact
that a purported DBE has been certified by a recipient. Such certification
does not preclude the Department from determining that the purported DBE,
or another firm that has used or attempted to use it to meet DBE goals,
should be suspended or debarred.
4. The Department may take enforcement action under 49 CFR Part 31,
Program Fraud and Civil Remedies, against any participant in the DBE
program whose conduct is subject to such action under 49 CFR part 31.
5. The Department may refer to the Department of Justice, for prosecution
under 18 U.S.C. 1001 or other applicable provisions of law, any person who
makes a false or fraudulent statement in connection with participation of a
DBE in any DOT -assisted program or otherwise violates applicable Federal
statutes.
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Attachment 4
Overall Goal Calculation
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Amount of Goal
1. The City of Round Rock's overall goal for FY 2011 is the following: the City will
expend 22% of future Federal Financial assistance in DOT -assisted contracts, which is
exclusive of FTA funds to be used for the purchase of transit vehicles.
2. During FY 2011, the City of Round Rock expects to award approximately $4,410,000
in contracts under pre -award authority granted by Letters of No Prejudice dated January
23, 2007 and August 26, 2009. Based on the overall goal, the City expects to expend
$970,200 with DBE firms during this fiscal year/project.
Methodology Used to Calculate Overall Goal
Step 1: 26.45(c)
Determine the base figure for the relative availability of DBEs.
The base figure for the relative availability of DBE's was calculated as follows:
Ready, willing, and able DBEs (396)
Base figure
All firms ready, willing and able (951)
When the City divided the numerator by the denominator the City arrived at the base
figure for the overall goal and that number was 42%.
Base Figure Analysis
Market Area:
Based on the rapid growth of the Central Texas area both in population and
development, the City selected the counties currently served by the Texas Department
of Transportation, Austin District, as its market area. The market area includes Bastrop,
Blanco, Burnet, Caldwell, Gillespie, Hays, Lee, Llano, Mason, Travis and Williamson
counties.
Sources of Data:
The most recent data source for identifying all firms ready, willing and able is the U.S.
Census Bureau North American Industry Classification System (NAICS) 2007 County
Business Patterns. The web address is
http://censtats.census.gov/cbpnaic/cbpnaic.shtml.
The data source for identifying ready, willing and able DBE firms is the Austin District
Texas Unified Certification Program (TUCP) DBE Category Listing. The listing used for
Fiscal Year (FY) 2011 goal setting is dated March 16, 2010. The web address is
http://www.txdot.gov/business/tucp/tucp-cat-dist.htm?dist=AUS. The listing is updated
periodically by the Texas Department of Transportation; therefore the on-line listing does
not match the listing used to develop the FY 2010 overall goal base figure.
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The U.S. Census Bureau NAICS 2007 County Business Patterns data lags the Austin
District TUCP DBE Category Listing by approximately three (3) years. The overall goal
base figure reflects a growth in the number of ready, willing and able DBE firms from
2006 to 2009, but the number of firms ready, willing and able remains stagnant at the
level reported in 2007. As a result, the base figure will be inflated. To maintain the
mathematical integrity of developing the base figure, the lag between the data sets is
addressed in Step 2, Adjust Base Figure.
Applicable North American Industry Classification System (NAICS) Codes:
The City will construct sidewalks, pedestrian amenities and streetscape improvements
along Main Street under pre -award authority granted by Letters of No Prejudice dated
January 23, 2007 and August 25, 2009. Based on the nature of the work, the City
selected the following NAICS codes for identifying the data required to calculate the
overall goal base figure. The data compiled for the market area, as defined above,
includes ready, willing and able DBE firms and all firms ready, willing and able to
perform the work.
221310 Water Supply and Irrigation Systems
This industry comprises establishments primarily engaged in operating water treatment
plants and/or operating water supply systems. The water supply system may include
pumping stations, aqueducts, and/or distribution mains. The water may be used for
drinking, irrigation, or other uses.
237310 Highway, Street, and Bridge Construction
This industry comprises establishments primarily engaged in the construction of
highways (including elevated), streets, roads, airport runways, public sidewalks, or
bridges. The work performed may include new work, reconstruction, rehabilitation, and
repairs. Specialty trade contractors are included in this group if they are engaged in
activities primarily related to highway, street, and bridge construction (e.g., installing
guardrails on highways).
238210 Electrical Contractors
This industry comprises establishments primarily engaged in installing and servicing
electrical wiring and equipment. Electrical contractors included in this industry may
include both the parts and labor when performing work. Electrical contractors may
perform new work, additions, alterations, maintenance, and repairs.
561730 Landscaping Services
This industry comprises (1) establishments primarily engaged in providing landscape
care and maintenance services and/or installing trees, shrubs, plants, lawns, or gardens
and (2) establishments primarily engaged in providing these services along with the
design of landscape plans and/or the construction (i.e., installation) of walkways,
retaining walls, decks, fences, ponds, and similar structures.
Tabulation of Ready, Willing and Able Firms
221310 Water Supply and Irrigation Systems
Ready, Willing and Able DBE Firms — 14
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Firms Ready, Willing and Able
Bastrop County 0
Blanco County 0
Burnet County 1
Caldwell County 5
Gillespie County 1
Hays County 7
Lee County 2
Llano County 3
Mason County 0
Travis County 18
Williamson County 7
Total for 221310 44
237310 Highway, Street, and Bridge Construction*
Ready, Willing and Able DBE Firms — 176
Firms Ready, Willing and Able
Bastrop County 1
Blanco County 4
Burnet County 5
Caldwell County 0
Gillespie County 3
Hays County 13
Lee County 2
Llano County 1
Mason County 2
Travis County 19
Williamson County 9
Total for 237310 59
* The number of ready willing and able DBE firms should never exceed the total
number of firms ready, willing and able to perform the work because DBE firms
are a subset of firms ready, willing and able to perform the work. As discussed
under Sources of Data, this is a direct result of the U.S. Census Bureau NAICS
2006 County Business Patterns data lagging the Austin District TUCP DBE
Category Listing by approximately three (3) years. The lag between the data
sets is addressed in Step 2, Adjust Base Figure.
238210 Electrical Contractors
Ready, Willing and Able DBE Firms — 94
Firms Ready, Willing and Able
Bastrop County 11
Blanco County 3
Burnet County 18
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Caldwell County 8
Gillespie County 12
Hays County 34
Lee County 11
Llano County 10
Mason County 4
Travis County 206
Williamson County 102
Total for 238210 419
561730 Landscaping Services
Ready, Willing and Able DBE Firms — 112
Firms Ready, Willing and Able
Bastrop County 13
Blanco County 2
Burnet County 17
Caldwell County 8
Gillespie County 10
Hays County 37
Lee County 2
Llano County 3
Mason County 1
Travis County 237
Williamson County 99
Total for 561730 429
Step 2: 26.45(d)
In Fiscal Year 2011 the City expects to award contracts exceeding $250,000 under pre-
award authority granted by the FTA. FY 2011 will be the second year utilizing the City's
DBE Program. The City's FY 2010 goal was 24% but the City only achieved 14.9%
participation. Based on the DBE bidder's list for FY 2010, historical data, 19% of the
ready, willing, and able bidders were DBE's. However, only two of the 13 U.S. Census
Bureau NAICS codes from FY 2010 are applicable to the FY 2011 program.
Consequently, the City will use 22% as the overall goal.
Adjust Overall Goal Base Figure
As discussed under Sources of Data, the U.S. Census Bureau NAICS 2007 County
Business Patterns data lags the Austin District TUCP DBE Category Listing by
approximately three (3) years. The total number of firms ready, willing and able to
construct sidewalks, pedestrian amenities and streetscape improvements along Main
Street grew from 2004 to 2007 by 89 percent. The growth of population and
development in Round Rock, Williamson County, and central Texas between 2006 and
2009 is similar to the growth experienced from 2003 to 2006, however, Central Texas is
experiencing an economic slow down, but not as severe as the rest of the country.
Without a way to measure the impact of the downturn on the total number of firms ready,
38 1 Page
willing and able to construct a structured parking facility with a terminal, the City is using
an 89 percent increase to project the number of firms ready, willing and able in 2009.
The projected total number of firms ready, willing and able is 1,797.
Adjust the base figure for the relative availability of DBEs.
The adjusted base figure for the relative availability of DBE's was calculated as follows:
Ready, willing, and able DBEs (396)
Adjusted Base figure =
All firms ready, willing and able (1,797)
When the City divided the numerator by the denominator the City arrived at the overall
goal of 22%.
Public Participation
The City published the goal information in the following publications: The Round Rock
Leader, The Austin -American Statesman, El Mundo, and The Villager. The DBE
Program was available for review from June 1, 2010 through June 30, 2010. Public
comments on the DBE Program were accepted from June 1, 2010 through July 15,
2010.
We received comments from these individuals and/or organizations: N/A
Summaries of these comments are as follows: N/A
The City's responses to these comments are: N/A
Public Outreach
September 25, 2009 Asian Chamber of Commerce — DBE Presentation
March 5, 2010 Vendor Day — DBE Presentation
March 17, 2010 Meet with Titus Industrial Group — DBE discussion
April 23, 2010 Meet with members of the Business Incubator Program, Austin
Hispanic Chamber of Commerce — DBE business opportunity
discussion
May 8, 2010 Business Incubator Program, Austin Hispanic Chamber of
Commerce — DBE Presentation
May 13, 2010
May 25, 2010
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Council presentation
Round Rock Chamber of Commerce Power Lunch — DBE
Presentation
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Attachment 5
Breakout of Estimated
Race -Neutral & Race Conscious Participation
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The City of Round Rock will meet the maximum feasible portion of its overall goal by
using race -neutral means of facilitating DBE participation. The City has one (1)
contracting opportunity scheduled for FY 2011. Consequently, the City plans to use the
following race -neutral means to increase DBE participation: encouraging prime
contractors to subcontract portions of work that they might otherwise perform with their
own forces; informing local chambers of commerce, minority, women's and general
contractor groups, community organizations and other organizations of specific contract
opportunities; and distributing the DBE Directory to the potential prime contractors.
We estimate that, in meeting our overall goal of 22%, we will obtain 0% from race -
neutral participation and 22% through race -conscious measures.
The following is a summary of the basis of our estimated breakout of race -neutral and
race -conscious DBE participation: the City did not estimate a breakout of race -neutral
and race -conscious DBE participation because the City does not have enough history
with the DBE Program. Starting with the FY 2010 program, the City is tracking
participation of DBE firms in local procurement programs in which there are DBE
contract goals. When the City exceeds the overall goal in two (2) consecutive years, the
City will reduce the use of contract goals proportionately in the following year.
In order to ensure that the City's DBE program will be narrowly tailored to overcome the
effects of discrimination, if the City uses contract goals we will adjust the estimated
breakout of race -neutral and race -conscious participation as needed to reflect actual
DBE participation (see 26.51(f)) and the City will track and report race -neutral and race
conscious participation separately. For reporting purposes, race -neutral DBE
participation includes, but is not necessarily limited to, the following: DBE participation
through a prime contract a DBE obtains through customary competitive procurement
procedures; DBE participation through a subcontract on a prime contract that does not
carry DBE goal; DBE participation on a prime contract exceeding a contract goal; and
DBE participation through a subcontract from a prime contractor that did not consider a
firm's DBE status in making the award.
The City will maintain data separately on DBE achievements in those contracts with and
without contract goals, respectively.
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Attachment 6
Forms for Demonstration of Good Faith Efforts
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FORM 1: DISADVANTAGED BUSINESS ENTERPRISE (DBE) UTILIZATION
The undersigned bidder/offeror has satisfied the requirements of the bid specification in
the following manner (please check the appropriate space):
The bidder/offeror is committed to a minimum of % DBE utilization
on this contract.
The bidder/offeror (if unable to meet the DBE goal of %) is committed
to a minimum of % DBE utilization on this contract and submits
documentation demonstrating good faith efforts.
Name of bidder/offeror's firm:
State Registration No.
By
(Signature)
Title
Name
(Printed)
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FORM 2: LETTER OF INTENT
Name of bidder/offeror's firm:
Address:
City: State: Zip:
Name of DBE firm:
Address:
City: State: Zip:
Telephone:
Description of work to be performed by DBE firm:
The bidder/offeror is committed to utilizing the above-named DBE firm for the work
described above. The estimated dollar value of this work is $
Affirmation
The above-named DBE firm affirms that it will perform the portion of the contract for the
estimated dollar value as stated above.
By:
(Signature)
(Printed Name) (Title)
If the bidder/offeror does not receive award of the prime contract, any and all
representations in this Letter of Intent and Affirmation shall be null and void.
(Submit this page for each DBE subcontractor.)
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Attachment 7
Regulation
Title 49 Code of Federal Regulation, Part 26
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A copy of Title 49 Code of Federal Regulation, Part 26, Participation by Disadvantaged
Business Enterprises in Department of Transportation Financial Assistance Programs,
can be viewed on the world-wide web at httr ://ecfr.gpoaccess.gov/cgi/t/text/text-
idx?c=ecfr&sid=20d364b05ceb079aff97f65288bcaf63&rqn=div5&view=text&node=49:1.
0.1.1.19&idno=49.
The Title 49 Code of Federal Regulation, Part 26, Participation by Disadvantaged
Business Enterprises is hereby incorporated by reference.
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Attachment 8
Texas Unified Certification DBE Program
Instructions and Application
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HOWDY!!!
Texas Unified
Certification
0111 Program
Welcome to the Federal Disadvantaged Business Enterprise (DBE) Program from the six
certifying agencies of the Texas Unified Certification Program (TUCP). The TUCP
follows Federal regulation 49 CFR, Part 26. The TUCP is a "one stop" certification
process for the Texas DBE Program, established October 1, 2002.
Six agencies have agreed to perform the certification processing of DBE Program
applications within the state of Texas by specific TUCP regions. The Texas Department
of Transportation (TxDOT), the North Central Texas Regional Certification Agency
(NCTRCA), the South Central Texas Regional Certification Agency (SCTRCA), the City
of Houston, the City of Austin, and the Corpus Christi Regional Transportation Authority
(CCTRCA) are responsible for DBE Program certification in the TUCP. (See Section 6
TUCP Certifying Agencies for specific regions, page 9).
Benefits of TUCP Certification in the DBE Program:
• Registers your business in the State of Texas and lists it in the DBE Directory
• Provides the opportunity to bid statewide as a certified DBE firm on all U.S.
Department of Transportation (DOT) transportation modes, including Aviation,
Highways, and Public Transportation
DBE PROGRAM APPLICATION
The DBE certification instructions and application can be found on pages 1-29. Once
your firm is certified as a DBE you will be included in the TUCP Directory.
The consolidated TUCP system allows you the opportunity to bid statewide, without
obtaining DBE Program certification from numerous agencies throughout the state.
Firms DBE certified by TUCP agencies will be included in the TUCP's DBE Directory.
The directory is on the INTERNET at:
http://www.txdot.gov/business/tucp/default.htm
If you have any questions about TUCP DBE Program certification, please contact the
serving DBE certification agency listed on page 9.
4.09 Uwe?
A \..:� TUCP ) E
". `, �`/ , a,°
'cation Qio
1. INTRODUCTION
TEXAS UNIFIED CERTIFICATION PROGRAM
DISADVANTAGED BUSINESS ENTERPRISES
INSTRUCTIONS AND APPLICATION
Fong 2099 (Rev. 02/10)
Page 2 of 31
A. All governmental entities in the State of Texas who receive funds from the U.S.
Department of Transportation have, as part of their operating procedures, an
economic program designed to increase participation of Disadvantaged
Business Enterprises (DBE) in their federally assisted contracts. The authority
for this program is 49 Code of Federal Regulations Part 26 (49 CFR Part 26).
B. There are six governmental agencies (Page 9) in the State of Texas certifying
DBEs capable of performing services and providing products, which can be
credited toward the overall annual DBE goal for entities receiving DOT funds.
Only those businesses which perform a commercially useful function can be
counted toward DBE goals on federally assisted contracts.
C. Certification must be obtained through your local certifying agency in
accordance with 49 CFR Part 26 for firms wanting to perform work as a DBE on
federally assisted contracts.
2. DEFINITIONS
A. Affiliate - firms are affiliates of each other when, directly or indirectly, a firm or a
third party (or parties) controls or has the power to control both; or there is
evidence that a relationship exists between or among parties that produces an
affiliation. In determining whether affiliation exists, consideration shall be given
to such factors as: common ownership, common management, and contractual
relationships.
B. Commercially Useful Function (CUF) - an element of work, under a contract,
that is measurable and observable and has actually been performed under
standards consistent with industry practice for which a monetary sum can be
assessed.
C. Disadvantaged Business Enterprise (DBE) - a small business concern as
defined pursuant to Section 3 of the Small Business Act and implementing
regulations, which is owned and controlled by one or more disadvantaged
individuals. Owned and controlled means a business, which is at least 51
percent owned by one or more socially and economically disadvantaged
individuals. In the case of any publicly owned business, at least 51 percent of
the stock must be owned by one or more socially and economically
disadvantaged individuals and whose management and daily business
operations are controlled by one or more of the socially and economically
disadvantaged individuals who own it.
Fonn 2099 (Rev. 02110)
Page 3of31
D. Personal Net Worth (PNW) - the net value of the assets of an individual
remaining after total liabilities are deducted. An individual's personal net worth
does not include the individual's ownership interest in an applicant or
participating DBE firm or the individual's equity in his or her primary place of
residence. An individual's personal net worth includes only his or her own share
of assets, held jointly, or as community property with the individual's spouse. A
contingent liability does not reduce an individual's net worth.
E. Socially and economically disadvantaged individuals - those individuals who are
citizens or lawfully admitted permanent residents of the United States and who
are as follows:
(1) Women
(2) Black Americans - includes persons having origins in any Black racial
groups of Africa.
(3)
Hispanic Americans - includes persons of Mexican, Puerto Rican,
Cuban, Dominican, Central or South American, or other Spanish or
Portuguese culture or origin, regardless of race.
(4) Native Americans - includes persons who are American Indians,
Eskimos, Aleuts, or Native Hawaiians.
(5)
Asian -Pacific Americans - includes persons whose origins are from
Japan, China, Taiwan, Korea, Burma (Myanmar), Vietnam, Laos,
Cambodia (Kampuchea), Thailand, Malaysia, Indonesia, the
Philippines, Brunei, Samoa, Guam, the U.S. Trust Territories of the
Pacific Islands (Republic of Palau), the Commonwealth of the
Northern Marinas Islands, Macao, Fiji, Tonga, Kiribati, Juvalu, Nauru,
Federated States of Micronesia, or Hong Kong.
(6) Subcontinent Asian Americans - includes persons whose origins are
from India, Pakistan, Bangladesh, Bhutan, the Maldives Islands,
Nepal, or Sri Lanka.
NOTE: Individuals listed above in 2 through 6 as a member of a particular
minority group must be recognized by their respective minority
community.
(7) Any additional groups whose members are designated as socially and
economically disadvantaged by the Small Business Administration.
(8) Other individuals as determined by the certifying entity to be
economically and socially disadvantaged.
Form 2099 (Rev. 02/10)
Page 4 of 31
3. ELIGIBILITY STANDARDS
To determine a firm's eligibility to participate in the DBE program, the firm's business
size, social and economic disadvantage, ownership and control (including
independence) will be evaluated. The standards set forth in 49 CFR Part 26 will be
used by the certifying entity. The following is a summary of the eligibility standards
set forth in 49 CFR Part 26.
(1) Disadvantaged status shall be determined on the basis of the individual's
claim that he or she is a member of one of the groups mentioned in
Section 2. e. (1)-(8) and is so regarded by that particular community.
However, the certifying entity is not required to accept this claim if it
determines the claim to be invalid.
(2) Only independent businesses may be certified as a DBE. An independent
business is one whose viability does not depend on its relationship with
another firm or firms. The ownership and control by disadvantaged
individuals shall be real, substantial, and continuing. It shall go beyond
the pro forma ownership of the firm as reflected in its ownership
documents. The disadvantaged individuals shall enjoy the customary
incidents of ownership and shall share in the risks and profits
commensurate with their ownership interests, as demonstrated by an
examination of the substance rather than form of arrangements.
Recognition of the business as a separate entity for tax or corporate
purposes is not necessarily sufficient for recognition as a DBE. In
determining whether a potential DBE is an independent business, the
following will be considered:
(a) Relationships with non -DBE firms in such areas as personnel,
facilities, equipment, financial and/or bonding support, and other
resources.
(b) Present or recent employer/employee relationships between the
disadvantaged owner and non -DBE firms or persons associated
with non -DBE firms.
(c) Relationships with prime contractors.
(d) The consistency of relationships between the potential DBE and
non -DBE firms with normal industry practices.
(3) The disadvantaged individuals shall also possess the power to direct or
cause the direction of the management and policies of the firm and to
make the day-to-day as well as major decisions on matters of
management, policy and operations. The firm shall not be subject to any
formal or informal restrictions, which limit the customary discretion of the
disadvantaged individual. There shall be no restrictions in by-law
provisions, partnership agreements, or charter requirements for
cumulative voting rights or otherwise that prevent the disadvantaged
Form 2099 (Rev. 02/10)
Page 5 (>1'31
individual, without the cooperation or vote of any non -disadvantaged
individual, from making a business decision of the firm.
(4) Individuals who are not socially and economically disadvantaged but are
involved in a DBE firm as owners, managers, employees, stockholders,
officers, and/or directors must not possess or exercise the power to
control the firm, or be disproportionately responsible for the operations of
the firm. The disadvantaged owners may delegate areas of management,
policy making, or daily operations of the firm, but such delegations must
be revocable and the disadvantaged owners must retain the power to hire
and fire persons to whom authority has been delegated.
(5) The disadvantaged owners must have an overall understanding of the
firm's operations; along with experience, managerial, and technical
competence. The disadvantaged owners must have the ability to
intelligently and critically evaluate information presented by other
participants in the firm's activities and to use this information to make
independent decisions concerning the firm's daily operations,
management, and policy-making. Generally, expertise limited to office
management, administration, or bookkeeping functions unrelated to the
principal business activities of the firm is insufficient to demonstrate
control.
(6) All securities, which constitute ownership and/or control of a corporation
for purposes of establishing it as a DBE, shall be held directly by
disadvantaged individuals. No securities held in trust or/by any guardian
for a minor shall be considered as held by disadvantaged individuals in
determining the ownership or control of a corporation, except when (1) the
beneficial owner of securities or assets held in trust is a disadvantaged
individual, and the trustee is the same or another such individual, or (2)
the beneficial owner of a trust is a disadvantaged individual who rather
than the trustee exercises effective control over the management, policy
making, and daily operations of the firm. Assets held in a revocable living
trust may be counted only in the situation where the same disadvantaged
individual is the sole grantor, beneficiary, and trustee.
The contributions of capital or expertise by the disadvantaged individual to
acquire interest in the firm shall be real and substantial. Examples of
insufficient contributions include a promise to contribute capital, an
unsecured note payable to the firm or its owners who are not socially and
economically disadvantaged, or the mere participation as an employee
rather than as a manager. If marital assets are used to acquire ownership
the applicant's spouse must irrevocably renounce and transfer all rights in
the ownership interest.
(8) To be determined economically disadvantaged, the personal net worth of
the individuals whose ownership and control are relied upon for DBE
certification cannot exceed $750,000.00.
(7)
Donn 2099 (Rev. 02/10)
Page 6 of 31
4. DENIAL OF INITIAL CERTIFICATION
When a business is denied initial certification it will receive a letter of explanation
from the certifying entity of why it was denied certification. The firm may appeal to
the certifying entity, in writing, for a review of their file or directly to the U.S.
Department of Transportation (DOT). To appeal a decision to DOT, the business
owner(s) must submit a letter giving the reason(s) he or she believes that the
business should be certified. Send the letter directly to the following:
U. S. Department of Transportation
Departmental Office of Civil Rights
External Policy and Program Development Division (S-33)
1200 New Jersey Avenue SE, W76-409
Washington, DC 20590
NOTE: The appeal to DOT must be filed no later than 90 days from the postmark
date of the certification denial.
A business that is denied certification by a certifying entity may not reapply for at
least 12 months from the date of the final decision. A copy of the decertification
notice will be forwarded to the TUCP database repository. A business that appeals
to the U.S. Department of Transportation cannot reapply to the certifying entity until
a final decision has been rendered on the appeal or 12 months, whichever is longer:
5. THIRD PARTY COMPLAINTS
Third party complaints: If any person has reason to believe that a business has been
wrongly granted certification as a DBE, they may advise the certifying entity. A
thorough investigation will be initiated upon receipt of a signed complaint. A
complaint may also be submitted directly to the U.S. DOT.
If you are a Woman, Black American, Hispanic American, Native American, Asian
Pacific American, or Subcontinent Asian American, you are presumed to be socially
and economically disadvantaged. Other persons knowing of your actual social and
economic condition, living standards, success in business, and other factors have
the right to challenge your recognition and certification as a DBE. If your status is
challenged, you will be given every opportunity to offer a defense. The challenge will
be fully investigated, heard, and a final determination made.
Form 2099 (Rev. 02110)
Page 7 of 31
6. INSTRUCTIONS
A. All businesses and trucking firms seeking to be certified as a DBE must
complete the entire application. All questions must be answered and all
information requested must be submitted. The applications must be legible,
complete, signed, dated, and notarized to be accepted for review. Failure to
provide the requested documents with the application will delay processing of
your application.
B. The certifying entity will evaluate the information contained in the application,
along with the facts learned during the on-site review to determine if the
business meets the eligibility standards to be certified as a DBE.
C. Applicant will be notified of the certifying entity decision by letter. If the firm is
certified as a DBE, the business will be added to the TUCP directory. The
directory will show the name of the business, address, telephone number, and
categories of work. A business may ask for expanded work capabilities as it
acquires experience in new areas.
Remember - the application must be complete, -every question answered. and the
application must be either typed or printed clearly in ink. All affidavits must be
notarized and all requested documents submitted: otherwise, the application will be
delayed in its processing. Use additional sheets as necessary and reference the
specific item(s) you are addressing.
A business must be functional and operating before applying for certification. It must
possess the resources to perform the work in which it is requesting to be certified. By
submitting this application and the accompanying information, the firm is
authenticating the veracity and accuracy of the statements made in the application.
Fenn 2099 (Rcv. 02/10)
Page S0131
Texas United Certification Program - Certifying Entities Regional Map
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Fa71.7:1 City of Austin
City of Houston
:1 Corpus Christi Regional Transportation Authority (CCTRTA)
North Central Texas Certification Agency (NCTRCA)
South Central Texas Certification Agency (SCTRCA)
Texas Department of Transportation (TXDOT)
Form 2099 (Rev. 02/10)
Page 9 of 31
7. TUCP CERTIFYING AGENCIES
Completed applications should be returned to the certifying agency that will service the Texas
county in which their home or corporate headquarters is located. Select the appropriate
address below:
City of Austin, Small and Minority Business
Resources Department
4201 Ed Bluestein
P.O. Box 1088
Austin, TX 78767-2516
Tel: (512) 974-7645
Fax: (512)974-7609
Email: dsmbrcertification@ci.austin.tx.us
City of Houston, Office of Affirmative Action
and Contract Compliance
611 Walker, 7th Floor
Houston, Texas 77002
Tel: (713) 837-9015
Fax: (713)837-9055
Email: mail@cityofhouston.net
Corpus Christi Regional Transportation
Authority (CCRTA)
5658 Bear Lane
Corpus Christi, TX 78405
Tel: (361) 289-2712 or (361) 289-2600 ext. 0
Fax: (361)289-0605
Email: mail@ccrta.org
North Central Texas Regional Certification
Agency (NCTRCA)
624 Six Flags Drive, Suite 100
Arlington, TX 76011
Tel: (817)640-0606
Fax: (817)640-6315
Email: mail@nctrca.org
South Central Texas Regional Certification
Agency (SCTRCA)
305 East Euclid, Ste. 102
San Antonio, TX 78212
Tel: (210) 227-4722
Fax: (210)227-5712
Email: info@sctrca.org
Texas Department of Transportation (TxDOT),
Office of Civil Rights
125 E. llth Street
Austin, TX 78701-2483
Tel: (866)480-2518
Fax: (512)486-5509
Email: tucpdata@dot.state.tx.us
Bastrop
Caldwell
Hays
Travis
Williamson
Brazoria
Chambers
Fort Bend
Galveston
Aransas
Bee
Goliad
Jim Wells
Karnes
Harris
Liberty
Montgomery
Waller
Kleberg
Live Oak
Nueces
Refugio
San Patricio
Collin Hood Parker
Dallas Jack Rockwall
Denton Johnson Somervell
Ellis Kaufman Tarrant
Erath Navarro Wise
Palo Pinto
Atascosa
Bandera
Bexar
Coma!
Frio
Guadalupe
Kendall
Kerr
McMullen
Medina
Uvalde
Wilson
ALL other remaining counties
Privacy Statement
The Texas Department of Transportation maintains the information collected
through this form. With few exceptions, you are entitled on request to be
informed about the information that we collect about you. Under §§552.421
and 552.023 of the Texas Government Code, you also are entitled to receive
and review the information. Under §559.004 of the Government Code, you are
also entitled to have us correct information about you that is incorrect.
Foran 2099 (Rev. 02/10)
Page 10of31
INSTRUCTIONS ICOR COMPLETING THE DISADVANTAGED BUSINESS I;N'1'E:RPRiSE (DBE)
PROGRAM UNIFORM CERTIFICATION APPLICATION
NOTE: if you require additional space t'or any question in this application, please attach additional sheets or copies as needed,
taking care to indicate on each attached sheet/copy the section and number of Ibis application to which it refers.
Section 1: CERTIFICATION INFORMATION
A. Prior/Other- Certifications
Check the appropriate box indicating for which program your firm is
currently certified. If you are already certified as a DBI, indicate in the
appropriate box the name of the certifying agency that has previously
certified your firm, and also indicate whether your firm has undergone an
onsite visit. If your firm has already undergone an ensile visit/review,
indicate the most recent date of that review and the state UCP that
conducted the review.
NOTE: If'your firm is currently certified under the SBA's S(a) and/or SD13
programs, you may neg have to complete this application. You should
contact your slate UCP to find out about a streamlined application process
for firms that are already certified under the 8(a) and SD13 programs.
13. Prior/Other Applications and Privileges
Indicate whether your firm or any of the persons listed has ever withdrawn
an application for a D13E program or an SBA 8(a) or SD[3 program, or
whether any have ever been denied certification, decertified, debarred,
suspended, or had bidding privileges denied or restricted by a_ily state or
local agency or Federal entity. If'your answer is yes, indicate the date of'
such action, identify the name of the agency, and explain fully the nature of
the action in the space provided.
Section 2: GENERAL INFORMATION
A. Contact Information
(1) State the name and title of the person who will serve as your firm's
primary contact under this application.
(2) State the legal name of your firm, as indicated in your firm's Articles
of Incorporation or charter.
State the primary phone number of'your firm.
Slate a secondary phone number, it'any.
State your firm's fax number, if any.
State your firm's or your contact person's email address.
State your firm's website address, if any.
State the street address of your firm (i.e., the physical location of its
offices - riot a post office box address).
(9) State the mailing address of'your firm, if' it is different from your
firm's street address.
B. Business Profile
(1) In the box provided, briefly describe the primary business and
professional activities in which your firm engages.
(2) State the Federal Fax 11) number of your firm as provided on your
firm's filed tax returns, if you have one. This could also be the Social
Security number of the owner of your firm.
(3) Stale the date on which your firm was officially established, as stated
in your firm's Articles of Incorporation or charter.
(4) Stale the date on which you and/or each other owner took ownership
of'the firm.
Check the appropriate box that describes the manner in which you
and each other owner acquired ownership of your firm. If you
checked "Other," explain in the space provided.
(6) Check the appropriate box that indicates whether your firm is "t'or
profit."
`'O'1'I?: if you checked "No," then you do NOT qualify for the 1)131=
program and therefore do not need to complete the rest of this
application. The D1)E program requires all participating firms be for-
profit enterprises.
(3)
(4)
(5)
(6)
(7)
(8)
(5)
c.
(1)
(2)
(3)
(4)
1).
Check the appropriate box that describes the legal form of ownership
of your linin, as indicated in your firm's Articles of Incorporation or
charter. If you chcckcd "Other," briefly explain in the space provided.
('heck the appropriate box that indicates whether your firm has ever
existed under different ownership, a different type of ownership, or a
different name. if you checked "Yes," specify which and briefly
explain the circumstances in the space provided.
Indicate in the spaces provided how many employees your firm has,
specifying the number of employees who work on a full-time and
part-time basis.
Specify the total gross receipts of your firm for each of the past three
years, as declared in your firm's filed tax returns.
Relationships with Other Businesses
Check the appropriate box that indicates whether your firm is co -
located at any of its business locations, or whether your firm shares a
telephone number(s), a post office box, any office space, a yard,
warehouse, other facilities, any equipment, or any office staff with
any other business, organization, or entity of any kind. If' you
answered "Yes," then specify the name of the other firm(s) and
briefly explain the nature ol'thc shared facilities or other items in the
space provided.
Check the appropriate box that indicates whether at present, or at any
time in the past:
(a) Your firm has been a subsidiary of any other firm;
(b) Your firm consisted ora partnership in which one or more of the
partners are other firms;
(c) Your firm has owned any percentage of any other firm; and
(d) Your firm has had any subsidiaries oI' its own.
If you answered "Yes" to any of the questions in (2)(a) -(d) or (3),
identify the name, address and type ot'business f'r each.
Check the appropriate box that indicates whether any other firm has
ever had an ownership interest in your ficin.
Immediate Family Member Businesses
(.'.heck the appropriate box that indicates whether any of your
immediate family members own or manage another company. An
"immediate family member" is any person who is your father,
mother, husband, wife, son, daughter, brother, sister, grandmother,
grandfather, grandson, granddaughter, mother -in -Taw, or father-in-
law. If you answered "Yes," provide the name ofeach relative, your
relationship to them, the name of the company they own or manage,
the type of business, and whether they own or manage the company.
Section 3: OWNERSHIP
Identify all individuals or holding companies with any ownership
interest in your firm, providing the information requested below (if
your firm has more than one owner, provide completed copies of this
section for each additional owner):
A. Background Information
(1) Give the name of the owner.
(2) State his/her title or position within your firm.
(3) Give his/her home phone nurnber.
(4) State his/her home (street) address.
(5) Check the appropriate box that indicates this owner's gender.
(6) Check the appropriate box that indicates this owner's ethnicity
(check all that apply). If you checked "Other," specify this owner's
ethnic group/identity not otherwise listed.
(7) Check the appropriate box to indicate whether this owner is a U.S.
citizen.
(8) If this owner is not a U.S. citizen, check the appropriate box that
indicates whcthcr this owner is a lawfully admitted permanent
resident. If this owner is neither a U.S. citizen nor a lawfully
adtnitted permanent resident of the U.S., then this owner is NO]'
eligible for certification as a DI3E owner. This, however, does not
necessarily disqualify your firm altogether from the DBE program
i1'another owner is a U.S. citizen or lawfully admitted permanent
resident and meets the program's other qualifying requirements. 0.
B. Ownership Interest
(1) State the number of years during which this owner has been an
owncr of your firm.
(2) Indicate the dollar value of this owner's initial investment to
acquire an ownership interest in your firm, broken down by cash,
real estate, equipment, and/or other investment.
(3) State the percentage of total ownership control of your fine that
this owner possesses.
(4) State the familial relationship of this owner to each other owner of
your firm.
(5) Indicate the number, percentage of the total, class, date acquired,
and method by which this owner acquired his/her shares of stock
in your firm.
(6) Check the appropriate box that indicates whether this owner
performs a management or supervisory function for any other
business. if you checked "Yes," state the name of the other
business and this owners function or title held in that business.
(7) Check the appropriate box that indicates whether this owner owns
or works for any other firm(s) that has ay relationship with your
firm. If you checked "Yes," identify the naive of'the other
business and this owner's function or title held in that business.
Briefly describe the nature of the business relationship in the
space provided.
C. Disadvantaged Status
NOTE: You only need to complete this section for each owner
that is applying for DBE qualification (i.e., for each owner who is
claiming to be "socially and economically disadvantaged" and
whose ownership interest is to be counted toward the control and
51% ownership requirements oldie DISE program)
(1) Indicate in the space provided the total Personal Net Worth
(PNW) of each owner who is applying for DI31 qualification. Use
the PNW calculator form at the end of this application to compute C.
each owner's PNW.
(2) (:heck the appropriate box that indicates whether any trust has
ever been created fbr the benefit of this disadvantaged owner. If
you answered "Yes," briefly explain the nature, history, purpose,
and current value of the trust(s).
Section 4: CONTROL
A. Identify your firm's Officers and Board of Directors:
(1) In the space provided, state the name, title, date of appointment,
ethnicity, and gender of each officer of your firm.
(2) In the space provided, state the name, title, date ofappointment,
ethnicity, and gender of each individual serving on your firm's
Board of Directors.
Font! 2099 (Rev. 02/10)
Page 11 0131
(3) Check the appropriate box that indicates whether any of your
firm's officers and/or directors listed above perform a
management or supervisory function for any other business. If
you answered "Yes," identify each person by name, his/her title,
the name of the other business in which s/he is involved, and his/
her function performed in that other business.
(4) ('heck the appropriate box that indicates whether any of your
firm's officers and/or directors listed above own or work for any
other tirm(s) that has a relationship with your firm. If you
answered "Yes," identify the name of the firm, the officer or
director, and the nature of his/her business relationship with that
other firm.
Identify your firm's management personnel (by name, title,
ethnicity, and gender) who control your firtn in the following
areas:
(1) Making financial decisions on your firm's behalf, including the
acquisition of lines ofcrcdit, surety bonds, supplies, etc.;
(2) Estimating and bidding, including calculation of cost estimates,
bid preparation and submission;
(3) Negotiating and contract execution, including participation in any
of your firm's negotiations and executing contracts on your firm`s
behalf;
(4) Hiring and/or firing of management personnel, including
interviewing and conducting performance evaluations;
(5) Field/Production operations supervision, including site
supervision, scheduling, project management services, etc.;
(6) Office management;
(7) Marketing and sales;
(8) Purchasing of major equipment;
(9) Signing company checks (for any purpose); and
(10) Conducting any other financial transactions on your firm's behalf
not otherwise listed.
(I I) Check the appropriate box that indicates whether any of the
persons listed in (1) through (10) above perform a management
or supervisory function for any other business. If you answered
"Yes," identify each person by name, his/her title, the name of
the other business in which s/he is involved, and his/her function
performed in that other business.
(12) Check the appropriate box that indicates whether any of the
persons listed in (1) through (10) above own or work for any
other firm(s) that has a relationship with your firm. If you
answered "Yes," identify the name of the firm, the name of the
person, and the nature of his/her business relationship with that
other firm.
Indicate your firm's inventory in the following categories:
(1) Equipment
State the type, make and model, and current dollar value of each
piece of equipment held and/or used by your firm. indicate
whether each piece is either owned or leased by your firm.
(2) Vehicles
State the type, make and model, and current dollar value of each
motor vehicle held and/or used by your firm. Indicate whether
each vehicle is either owned or leased by your firm.
(3) Office Space
State the street address of each office space held and/or used by
your firm. Indicate whether your firm owns or leases the office
space and the current dollar value of that property or its lease.
(4) Storage Space
State the street address of each storage space held andlor used by
your firm. Indicate whether your firm owns or leases the storage
space and the current dollar value of that property or its lease.
D. Does your firm rely on any other firm for management functions
or employee payroll?
Check the appropriate box that indicates whether your firm relies on
any other firm for management functions or for employee payroll. If
you answered "Yes," briefly explain ibe nature of that reliance and the
extent to which the other firm carries out such functions.
E. Financial Information
(1) Banking Information
(a) State the name of your firm's bank.
(b) State the main phone ntnnber of your lirm's bank branch.
(c) State the address ofyour firm's bank branch.
(2) Bonding Information
(a) State your firm's Binder Number.
(b) State the name of your firm's bond agent and/or broker.
(c) State your agent's/broker's phone number.
(d) State your agent's/broker's address.
(e) State your firm's bonding limits (in dollars), specifying both
the Aggregate and Project Limits.
F. Identify all sources, amounts, and purposes of money loaned to
your firm, including the names of persons or firms securing the
loan, if other titan the listed owner:
State the name and address of each source, the name of the person
sectoring the loan, the original dollar amount and the current balance
of each loan, and the purpose for which each loan was made to your
firm.
G.
11.
L.
Form 2099 (Rev. 02/10)
Page 12 of 3I
List all contributions or transfers of assets to/from your firm and
to/from any of its owners over the past two years:
Indicate in the spaces provided, the type of contribution or asset that
was transferred, its current dollar value, the person or firm from
whom it was transferred, the person or firm to whom it was
transferred, the relationship between the two persons and/or firms,
and the date of the transfer.
List current licenses/permits held by any owner or employee of
your firm.
I.,ist the name of each person in your firm who holds a professional
license or permit, the type of license or permit, the expiration date of
the permit or license, and the license/permit number and issuing State
of'the license or permit.
List the three largest contracts completed by your firm in the
past three years, if any.
List the name of each owner or contractor for each contract, the name
and location of the projects under each contract, the type of work
performed on each contract, and the dollar value of each contract.
3. List the three largest active jobs on which your firm is currently
working.
For each active job listed, state the name of the prune contractor and
the project number, the location, the type of work performed, the
project start date, the anticipated completion date, and the dollar
value of the contract.
AFFIDAVIT & SIGNATURE;
Carefully read the attached affidavit in its entirety. Fill in the required
information for each blank space, and sign and date the affidavit in
the presence of a Notary Public, who must then notarize the form.
Disadvantaged Business Enterprise Program
49 CFR Part 26
Uniform Certification Application
Form 2099 (Rev. 02110)
Page 13 of 31
ROADMAP FOR APPLICANTS
1. Should I apply?
• Is your firm at least 51% -owned by a socially and economically disadvantaged individual(s) who
also controls the firm?
• Is the disadvantaged owner a U.S. citizen or lawfully admitted permanent resident of the U.S.?
• Is your firm a small business that meets the Small Business Administration's (SBA's) size standard
and does not exceed $22.41 million in gross annual receipts?
• Is your firm organized as a for-profit business?
cis' If you answered "Yes" to all of the questions above, you may he eligible to participate in
the U.S. DOT DBE program.
2. Is there an easier way to apply?
If you are currently certified by the SBA as an 8(a) and/or SDB firm, you may be eligible for a streamlined
certification application process. Under this process, the certifying agency to which you are applying will
accept your current SBA application package in lieu of requiring you to fill out and submit this form.
NOTE: You must still meet the requirements for the DBE program, including undergoing an on-site
review.
3. Be sure to attach all of the required documents listed in the Documents Check List at the end of this form
with your completed application.
4. Where can I find more information?
• U.S. DOT - btt.p,;//nsdbuwek.dot.g;ov/I)t3.I.:. Prog!:ai1!/i.n ....cfm (this site provides useful links to the rules
and regulations governing the DBE program, questions and answers, and other pertinent information)
• SBA - bet.p;llw.w...censtis,gov/cos/,www/naics/ (provides a listing of NAICS codes) and
http://www.sba.gov/size/indextableofsize.html (provides a listing of NAICS codes)
• 49 CFR Part 26 (the rules and regulations governing the DBE program)
Under Sec. 26.107 of 49 CFR Part 26, dated February 2, 1999, if at any time, the Department or a recipient has reason to
believe that any person or firm has willfully and knowingly provided incorrect information or made false statements, the
Department may initiate suspension or debarment proceedings against the person or firm under 49 CFR Part 29,
Governinentwide Debarment and Suspension (nonprocurement) and Governmentwide Requirements for Drug-free
Workplace (grants), take enforcement action under 49 CFR Part 31, Program Fraud and Civil Remedies, and/or refer the
matter to the Department of Justice for criminal prosecution under 18 U.S.C. 1001, which prohibits false statements in
Federal programs.
Section 1: CERTIFICATION INFORMATION
A. Prior/Other Certifications
Foran 2099 (Rev. 02/10)
Page 14 of 31
Is your firm currently certified for
any of the following programs?(If
Yes, check appropriate box(es))
0 DBE
Name of certifying agency:
Has your firm's state UCP conducted an on-site visit?
Yes, on / / L]No
(6) E-mail: (7) Website (ifhave one):
0 8(a)
STOP! If you checked either the 8(a) or SDB box, you may not have to complete this
application. Ask your state UCP about the streamlined application process under the
SBA -DOT MOU.
[]SDB
Zip:
B. Prior/Other Applications and Privileges
Has your firm (under any name) or any of its owners, Board of Directors, officers or management personnel, ever withdrawn an
application for any of the programs listed above, or ever been denied certification, decertified, or debarred or suspended or otherwise
had bidding privileges denied or restricted by any state or local agency, or Federal entity?
Yes, on / 1 ON°
If Yes, identify State and name of state, local, or Federal agency and explain the nature of the action:
Section 2: GENERAL INFORMATION
A. Contact Information
(1) Contact person and title:
(2) Legal name of firm:
(3) Phone It:
(4) Other Phone #: (5) Fax #:
(6) E-mail: (7) Website (ifhave one):
(8) Street address of firm (No P.O. Box):
City:
County/Parish:
State:
Zip:
(9) Mailing address of firm (ifdifferent):
City:
County/Parish:
State:
Zip:
B. Business Profile
(I) Describe the primary activities of your firm:
(2) Federal Tax ID#:
(3) This firm was established on
(4) I/We have owned this firm since:
(5) Method of acquisition (check all that apply):
0 Started new business j Bought existing business Inherited business 0 Secured concession
D Merger or consolidation ❑ Other (explain)
(6) Is your firm "for profit"? 0 Yes fl No
()STOP! If your firm is NOT for-profit, then you do NOT qualify for this program
and do NOT need to fill out this application.
Pone 2099 (Rev. 02/10)
Page 15 of 31
(7) Type of firm (check all that apply):
• Sole Proprietorship
❑ Partnership
❑ Corporation
❑ Limited Liability Partnership
❑ Limited Liability Corporation
❑ Joint Venture
❑ Other, Describe:
(8) Has your firm ever existed under different ownership, a different type of' ownership, or a different name?
❑ Yes 0 No
If Yes, explain:
(9) Number of employees: Full-time Part-time Total
(10) Specify the gross receipts of the finn for the last 3 years: Year Total receipts $
Year Total receipts $
Year Total receipts $
C. Relationships with Other Businesses
(1) Is your firm co -located at any of its business locations, or does it share a telephone number, P.O. Box, office space, yard, warehouse,
facilities, equipment, or office staff, with any other business, organization, or entity?
❑ Yes ❑ No
If Yes, identify: Other Finn's name:
Explain nature of shared facilities:
(2) At present, or at any time in the
past, has your firm:
(a) been a subsidiary of any other firm? El Yes [iNo
(b) consisted of a partnership in which one or
more of the partners are other firms? ❑Yes No
(c) owned any percentage of any other firm? I Yes ❑ No
(d) had any subsidiaries? ❑Yes ❑No
(3) Has any other firm had an ownership interest in your firm at present or at any time in the past? ❑Yes No
(4) If you answered "Yes" to any of the questions in (2)(a) -(d) and/or (5), identify the following for each (attach extra sheets, tf needed):
Name Address Type of Business
1.
3.
D. Immediate Family Member Businesses
Do any of your immediate family members own or manage another company? ❑Yes ❑ No
If Yes, then list (attach extra streets, if needed):
Name Relationship Company_
Type of Busing .s Own or Manage?
Section 3: OWNERSHIP
l orm 2099 (Rev. 02/10)
Page 16 of 31
Identify all individuals or holding companies with any ownership interest in your firm providing the information requested below
(If more than one owner, attacl_sexerale .sheets for each additional owner);
A. Back round Information
(1) Nance: (2) Title: (3) Home Phone #:
(4) Home Address (street and nwnbet): City: State: Zip:
(5) Gender: []Male []f=emale
(6) Ethnic group membership (Check all that apply):
[ Black 11 Hispanic $ Native American ❑ Asian Pacific
(7) U.S. Citizen: []Yes ONo
(8) Lawfully Admitted Permanent Resident:
LlYes EI No
II Subcontinent Asian ❑ Other (speciji)
B. Ownership Interest
(1) Number of years as owner:
(2) Initial krvestment Type Dollar Value
(3) Percentage owned:
to acquire ownership Cash S
interest in firm: Real Estate $
Equipment S
Other S
(4) Familial relationship to other owners:
(5) Shares of Stock: Number: )'ercentag :
Class: Data lcquir_ed: Method Acquired:
(6) Does this owner perform a management or supervisory function for any other business? [Yes []No
If Yes, identify: Name of Business: Function/Title:
(7) Does this owner own or work for any other firm(s) that has a relationship with this firm (e.g_, ownership interest, shared office space,
,financial investments, equipment, leases, personnel sharing, etc.)? [IYes El No
If Yes, identify: Name of Business: Function/Title:
Nature of Business Relationship:
C. Disadvantaged Statics - NOTE: Complete this section only for each owner applying for DBE qualification
(i.e., for each owner claiming to be socially and economically disadvantaged)
(1) What is the Personal Net Worth (PNW) of the owner(s) applying for DBE qualification? (Use and attach the Personal iVet Worth
calculator for,n at the end (Oils application: attach additional sheets (furore than one owner is applying)
(2) Has any trust been created for the benefit of this disadvantaged owner(s)? ElYes DNo
If Yes, explain (aiach additional sheets i/'needed):
Section 4: CONTROL
lonn 2099 (Rev. 02/10)
Page 17°01
31
A. Identify your firm's Officers & Board of Directors Of additional space is required, attach a separate sheet):
(1) Officers of the Company
Name
Name
Title
Date Appointed
Ethnicity
Gender
(a)
(b)
(b)
(a)
(b)
(c)
(3) Negotiating and Contract
Execution
(a)
(d)
(b)
(e)
(a)
(2) Board of Directors
(a)
(5) Field/Production Operations
Supervisor
(a)
(b)
(b)
(6) Office management
(c)
(b)
(d)
(7) Marketing/Sales
(a)
(e)
(b)
(3) Do any of the persons listed in (1) and/or (2) above perform a management or supervisory function for any other business?
[]Yes [ONo
If Yes, identify for each: Person: Title:
Business: Function:
(4) Do any of the persons listed (1) and/or (2) above own or work for any other firm(s) that has a
this firm (e.g_. ownership interest, shared o/Jice space, financial investments. equipment, leases, personnel sharing. etc.)?
If Yes, identify for each: Firm Name: Person:
Nature of Business Relationship:
relationship with
• Yes LI N0
(b)
13. Identify your firm's management personnel who control your firm in the following areas (If more than two persons, attach a separate
sheet):
Name
Title
Ethnicity
Gender
(1) Financial Decisions
(responsibility for acquisition of lines of
credit. surely bonding. supplies. etc.)
(a)
(b)
(2) Estimating and bidding
(a)
(b)
(3) Negotiating and Contract
Execution
(a)
(b)
(4) Hiring/firing of management
personnel
(a)
(b)
(5) Field/Production Operations
Supervisor
(a)
(b)
(6) Office management
(a)
(b)
(7) Marketing/Sales
(a)
(b)
(8) Purchasing of major
equipment
(a)
(b)
(9) Authorized to Sign Company
Checks (for any purpose)
(a)
(b)
(10) Authorized to make
Financial "Transactions
(a)
(b)
Form 2099 (Rev. 02/10)
Page I8of3I
(11) Do any of the persons listed in (1) through (10) above perform a management or supervisory function for any other business?
[]Yes [INo
If Yes, identify for each: Person:
Business:
Title:
Function:
(12) Do any of the persons listed in (1) through (10) above own or work for any other firm(s) that has a relationship with this iirin (c.g.,
otivne,sllip interest, shared of/ice space, jinancial investments, equipment. leases, personnel sharing. etc.)? [I Yes No
If Yes, identify for each: Firm Name: Person:
Nature of Business Relationship:
C. Indicate your firm's inventory in the following categories (attach additional sheets if needed):
(1) Equipment
Type of Equipment
Make/Model
Current Value
Owned or Leased?
(a)
(b)
(c)
(2) Vehicles
Type of Equipment
Make/Model
Current Value
Owned or Leased?
(a)
(b)
(c)
(3) Office Space
Street Address
Owned or Leased?
Current Value of Property or Lease
(a)
(b)
(4) Storage Space
Street Address
Owned or Leased?
Current Value of Property or Lease
(a)
(b) ,
D. Does your firm rely on any other firm for management functions or employee payroll? Lives []No If yes, explain:
E. Financial Information
(1) Banking Information:
(a) Name of bank:
(c) Address of bank:
(b) Phone No:
City: State: Zip:
Form 2099 (Rev. 02/10)
Page 19 01'31
(2) Bonding Information: If you have bonding capacity, identify:
(b) Name of agent/broker:
(d) Address of agent/broker:
(e) Bonding limit: Aggregate limit S
(a) Binder No:
(c) Phone No:
City:
Project limit S
State: Zip:
F. Identify all sources, amounts, and purposes of money loaned to your firm, including the names of any persons or
firms securing the Loan, if other than the listed owner:
Name of Source
Address of Source
Name of Person
Securing the Loan
Oril;inal
Amount
Current
Balance
Purpose of Loan
1.
2.
3.
G. List all contributions or transfers of assets to/front your firm and to/from any of its owners over the past two years
(attach additional sheets if needed):
Contribution/Asset
Dollar Value
From Whom
Transferred
To Whom
Transferred
Relationship
Date of
Transfer
1.
2.
3.
H. List current licenses/permits held by any owner and/or employee of your firm (e.g., contractor, engineer; architect,
etc.) (attach additional sheets ifneeded):
Name of License/Permit Holder
Type of License/Permit
Expiration Date
License Number and State
2.
3.
1. List the three largest contracts completed by your firm in the past three years, if any:
Name of
Owner/Contractor
Name/Location of
Project
Type of Work Performed
Dollar Value of
Contract
1.
Dollar Value
of Contract
1.
3.
J. List the three largest active jobs on which your firm is currently working:
Name of Prime
Contractor and Project
Number
Location of Project
Type of Work
Project
Start Date
Anticipated
Completion
Date
Dollar Value
of Contract
1.
2.
3.
Form 2099 (Rev. 02/10)
Page 20 of 31
AFFIDAVIT OF CERTIFICATION
This form inttst be signed and notarized for each owner upon which disadvantaged status is relied.
A MATERIAL OR FALSE STATEMENT OR OMISSION MADE IN CONNECTION WITH THIS
APPLICATION IS SUFFICIENT CAUSE FOR DENIAL OF CERTIFICATION, REVOCATION OF A
PRIOR APPROVAL, INITIATION OF SUSPENSION OR DEBARMENT PROCEEDINGS, AND MAY
SUBJECT THE PERSON AND/OR ENTITY MAKING THE FALSE STATEMENT TO ANY AND ALL
CIVIL AND CRIMINAL PENALTIES AVAILABLE PURSUANT TO APPLICABLE FEDERAL AND
STATE LAW.
I , swear or affirm under penalty of law that I am
(full name printed)
of applicant firm and that
(title) (firm name)
I have read and understood all of the questions in this application and that all of the foregoing information and statements
submitted in this application and its attachments and supporting documents are true and correct to the best of my knowledge,
and that all responses to the questions are full and complete, omitting no material information. The responses include all
material information necessary to fully and accurately identify and explain the operations, capabilities and pertinent history
of the named Linn as well as the ownership, control, and affiliations thereof.
I recognize that the information submitted in this application is for the purpose of inducing certification approval by a
government agency. I understand that a government agency may, by means it deems appropriate, determine the accuracy and
truth of the statements in the application, and 1 authorize such agency to contact any entity named in the application, and the
named firm's bonding companies, banking institutions, credit agencies, contractors, clients, and other certifying agencies for
the purpose of verifying the information supplied and determining the named firm's eligibility.
1 agree to submit to government audit, examination and review of books, records, documents and files, in whatever form they
exist, of the named firm and its affiliates, inspection of its place(s) of business and equipment, and to permit interviews of its
principals, agents, and employees. I understand that refusal to permit such inquiries shall be grounds for denial of
certification.
If awarded a contract or subcontract, 1 agree to promptly and directly provide the prime contractor, if any, and the
Department, recipient agency, or federal funding agency on an ongoing basis, current, complete and accurate information
regarding (1) work performed on the project; (2) payments; and (3) proposed changes, if any, to the foregoing arrangements.
I agree to provide written notice to the recipient agency or Unified Certification Program (UCP) of any material change in
the information contained in the original application within 30 calendar days of such change (e.g., ownership, address,
telephone number, etc.).
I acknowledge and agree that any misrepresentations in this application or in records pertaining to a contract or subcontract
will be grounds for terminating any contract or subcontract which may be awarded; denial or revocation of certification;
suspension and debarment; and for initiating action under federal and/or state law concerning false statement, fraud or other
applicable offenses.
1 certify that I am a socially and economically disadvantaged individual who is an owner of the above -referenced firm
seeking certification as a Disadvantaged Business Enterprise (DBE). In support of my application, I certify that I am a
member of one or more of the following groups, and that I have held myself out as a member of the group(s) (check all that
apply):
❑ Women
❑ Black American
❑ Hispanic American
❑ Native American
❑ Asian - Pacific American
❑ Subcontinent Asian American
❑ Other (specify)
Foran 2099 (Rev. 02/10)
Page 21 of 31
[ certify that 1 am socially disadvantaged because 1 have been subjected to racial or ethnic prejudice or cultural bias, or have
suffered the effects of discrimination, because of my identity as a member of one or more of the groups identified above,
without regard to my individual qualities.
1 further certify that my personal net worth does not exceed $750,000, and that 1 am economically disadvantaged because
my ability to compete in the free enterprise system has been impaired due to diminished capital and credit opportunities as
compared to others in the same or similar line of business who are not socially and economically disadvantaged.
l declare under penalty of perjury that the information provided in this application and supporting documents is true and
correct.
Executed on
Signature
(Date)
(DQE Applicant)
Date State of County of
Before me, a notary public, on this day personally appeared
known to me to be the person whose name is subscribed to the foregoing document and, being by me first duly sworn,
declared that the statements therein contained are true and correct.
(Seal)
Notary Public Commission Expiration
Fonu 2099 (Rev. 02/10)
Page 22of31
Texas Unified Certification Program
Supplemental Information Form
Proof of Group Membership:
In addition to the documents listed in the application checklist, please provide one of the following:
(Note - the item you provide should demonstrate proof of your membership in a disadvantaged group.)
Select One:
Birth Certificate
E Passport
[] Tribal Roll Card
0 Tribal Voter Registration Certificate
[l Naturalization Papers
Note - You may be requested to provide additional documentation if the information is insufficient to prove
disadvantaged group membership.
Font" 2099 (Rev. 02/10)
Page 23 of 31
PERSONAL NET WORTH STATEMENT
Complete a form for: (1) each socially disadvantaged proprietor, or (2) each socially disadvantaged limited and general
partner whose combined interest total 51% or more, or (3) each socially disadvantaged stockholder owning 51% or more of
voting stock. An individual's personal net worth includes only his or her share of the assets held jointly or as community
property with the individual's spouse.
Name:
Date:
Residence Address:
Residence Phone:
City, State & Zip Code:
Business Name:
Residence Phone:
PERSONAL FINANCIAL STATEMENT
As of / / . In determining net worth, EXCLUDE
individual ownership interest in the applicant business
Round all numbers to the nearest dollar.
and personal residence. If married use only 'A of marital assets.
ASSETS
LIABILITIES
Cash on hand and in bank $
Accounts
Notes
Others
Installment
Installment
Loan on
Mortgages
[Except
Unpaid
Other
Total
Net
(Total
Payable $
Savings Accounts $
Payable to Banks and
$
IRA or Other Retirement Account $
(Complete Section 1)
Account (Auto) $
Accounts and Notes Receivable $
Account (Other) $
Life Insurance - $
Life Insurance $
Cash Surrender Value Only (Complete Section 7)
Stocks and Bonds $
on Real Estate $
(Complete Section 2)
Real Estate $
for personal residence] (Complete Section 3)
Taxes $
[Except for personal residence] (Complete Section 3)
Automobile(s) --- Present Value $
(Complete Section 5)
Liabilities $
Other Personal Property $
(Complete Section 6)
Liabilities $
(Complete Section 4)
Other Assets $
Worth $
(Complete Section 4)
Total Assets $
Assets minus Total Liabilities)
Other Source of Income:
Salary/Commissions $
Other Contingent
As Endorser
Legal Claims
Liabilities:
or Co-worker $
Net Investment Income $
and/or Judgments $
Foran 2099 (Rev. 02/10)
Page 24 of 31
Section 1. Notes payable to Bank and Others (Use attachments if necessary. Each attachment must be identified as a part of
this statement and signed.)
Name and Address of Note Holders
Original
Balance
Current Balance
Payment
Amount
Frequency
(weekly,
monthly, etc.)
How Secured or
Endorsed; Type
of Collateral
Section 2. Stocks and Bonds. (Use attachments if necessary. Each attachment must be identified as a part of this statement
and signed.) NOTE: Must be within five (5) days of statement date.
Number of Shares
Original Balance
Cost
Market Value
Quotation or
Exchange
Date of
Quotation or
Exchange
Total Value
Section 3. Real Estate Owned. (Do not include your personal residence. List each parcel separately. Use attachments if
necessary. Each attachment must be identified as a part of this statement and signed.)
Property A
Property B
Property C
Type of Property
Address
Date Purchased
Original Cost
Present Market Value
Name and Address of Mortgage
Holder
Mortgage Account Number
Mortgage Balance
Amount of Payment per
Month/Year
Status of Mortgage
Foran 2099 (Rev. 02/10)
1'agc 25 of 31
Section 4. Other Personal Property and Other Assets. (Describe, and if any is pledged as security, state name and address of
lien holder, amount of lien, terms of payment, and if delinquent, describe.)
Section 5. Unpaid Taxes. (Describe in detail, as to type, to whom payable, when due, amount, and to what property, if any,
a tax lien attaches.)
Section 6. Other Liabilities (Describe in detail).
Section 7. Life Insurance Held. (Give face amount and cash surrender value of policies - name of insurance company and
beneficiaries.)
Section 8. Transfer of Assets.
Have you, the individual claiming disadvantaged status, transferred any assets within two (2) years, in full or in part, to
a spouse or any other person or entity, including a trust? QYes ■ No
If yes, provide the following information as an attachment: the date of transfer, to whom the assets were transferred,
amount paid for the assets, the market value of the assets at the time of transfer.
NOTE: Individuals may exclude assets transferred to an immediate family member that are consistent with the
customary recognition of special occasions and may also exclude any transfers to an immediate faInily member for
educational, medical, or essential support purposes.
Please provide copies of complete personal income tax returns, including all schedules, W -2s, and 1099 forms. 49 CFR Part
26 and federal law classify nil in formation submitted with this form as confidential This form or its information cannot be
released to any person, governmental or commercial entity without the written permission of the person submitting the
information.
Fore 2099 (Rev. 02/10)
Page 26 oi' 3 l
PERSONAL NET WORTH AFFIDAVIT
The undersigned swear/affirm that the foregoing information and statements are true and correct, including all material and
information necessary to identify and explain the financial net worth of
(Name of Individual)
Further, the undersigned agrees to permit the TUCP and/or U.S. Department of Transportation (DOT) as part of this
certification process to interview owners, principals, officers, and employees; and to audit or examine books, records, and
files of the above named individual.
If at any time the TUCP or DOT has reason to believe that any person or firm has willfully and knowingly provided
incorrect information or made false statements, your file may be referred to the General Counsel of DOT. The General
Counsel may initiate debarment procedures in accordance with 41 CFR 1-1.604 and 12-1.062 and/or refer the matter to the
Department of Justice under U.S.C. 1001, as the General Counsel deems appropriate.
NOTE: Under Title 18 U.S.C. Section 1001 and Title 15 U.S.C. Section 645, airy person who misrepresents a firm's status as
a small disadvantaged business concern; or makes false statements in order to influence the certification process in any way;
or to obtain a government contract, shall be subject to fines of up to $500,000 and imprisonment of up to 10 years, or both.
The burden of proving the financial net worth is the individual's. The Agency reserves the right to request any additional
information deemed necessary to determine if an individual is economically disadvantaged. Failure to provide requested
information within the time specified is grounds for termination of the process.
Naive Signature
Title Date
Date State of County of
On this day before me appeared (name) with proper
identification, who being duly sworn, did execute the foregoing affidavit and did aver that he or she was properly authorized
to execute this affidavit and did so as his or her free act/deed.
(Seal)
Notary Public Commission Expiration
Name:
Form 2099 (Rev. 02/10)
Page 27of31
AFFIDAVIT OF MANAGERIAL TECHNICAL COMPETENCE
Special qualification in the work areas requested in DBE Application:
Professional licenses held:
Union/professional association membership:
Education/Technical training:
School Dates
# of hrs.
Degree Field
Position with applicant firm:
Title: Salary:
Dates employed: From: To: Hours per week:
Duties and responsibilities:
Previous employment: (list most recent employment first, may continue on back of page)
Firm:
Type of business: Location:
Dates employed: From: To: Hours per week:
Title:
Number of persons supervised:
Duties and responsibilities:
Salary:
Type of employees:
Knowledge, skills and abilities:
Hiring:
Contracting:
Purchasing:
Technical competence related to firm's operations:
Dort 2099 (Rev. 02/10)
I'agc 28 of 31
Please identify the areas (Districts) of Texas in which your firm is ready, willing and able (based on employees and
equiment) to work on TxDOT contracts. For some contracts requiring large staff and/or equipment, such as highway
construction projects, keep in mind that you must either transport your equipment from your home office to the project site
(or arrange for lease/rental of equipment and delivery to the project site) and secure lodging facilities for your employees.
For example: If your office is in Beaumont, TX and you indicate that you can work in all 25 Districts, then be
prepared to perform highway project work with your equipment and employees in Amarillo, El Paso, Laredo,
Texarkana and all other TxDOT districts.
I am willing to work on TxDOT projects in the following Districts. (Select at least ONE, or up to TEN preferred work area(s),
unless Statewide is preferred)
Preferred Work Area(s)
❑ Statewide Work Area (ALL 25 Districts)
❑ Abilene (8)
❑ Brownwood (22)
❑ El Paso (15)
❑ Lufkin (11)
❑ San Antonio (15)
❑ Amarillo (4)
❑ Bryan (17)
❑ Fort Worth (2)
0 Odessa (6)
❑ Tyler (10)
❑ Atlanta (19)
❑ Childress (25)
❑ Houston (12)
❑ Paris (1)
❑ Waco (9)
❑ Austin (14)
❑ Corpus Christi (16)
0 Laredo (22)
O Pharr (21)
❑ Wichita Falls (3)
TxDOT Districts
ABL
AMA
ATL
AUS
BMT
BWD
BRY
CHS
CRP
DAL
ELP
FTW
HOU
LRD
LBB
LFK
ODA
PAR
PHR
SST
SAT
TYL
WAC
WFS
YKM
❑ Beaumont (20)
❑ Dallas (18)
❑ Lubbock (5)
❑ San Angelo (7)
❑ Yoakum (13)
Abilene
Amarillo
Atlanta
Austin
Beaumont
Brownwood
Bryan
Childress
Corpus Christi
Dallas
El Paso
Fort Worth
Houston
Laredo
Lubbock
Lufkin
Odessa
Paris
Pharr
San Angelo
San Antonio
Tyler
Waco
Wichita Falls
Yoakum
1'ontt 2099 (Rev. 02/10)
Page 29of31
NATURE OF BUSINESS
Check the type of work that makes up 75 percent or more of the dollar volume of work done by your business. Should your
firm's type not be listed below, indicate service provided and percent of dollar value.
❑ Asphalt - includes seal coats and surface treatments, limestone rock asphalt, cold -mix asphaltic concrete
pavement, hot mix asphaltic concrete pavement, etc.
❑ Concrete Paving and Incidentals -- includes jointed concrete pavement and continuously reinforced concrete
pavement
❑ Earthwork, Base and Subbase - includes preparing ROW, clearing, removing old concrete, roadway and
channel excavation, embankments, subbase courses, base courses, etc.
❑ Fencing - includes wire, chain link and metal beam guard fence, metal bridge railing, etc.
❑ Hauling - includes hauling of base material, gravel, sand, hot mix, etc.
❑ Illumination - includes placement of conduit and wire, poles, roadway and bridge lights, etc.
❑ Landscaping - includes roadside planting, erosion control, sodding, seeding, etc.
❑ Major Structures - includes structural excavation, drill shafts, piling, concrete for columns, bents, abutments,
slabs, structural steel, rebar, etc.
❑ Material Suppliers - suppliers of construction materials kept in inventory for public sale (60% credit).
Manufacturers and suppliers (100% credit).
❑ Minor Structures and Miscellaneous Concrete - includes COM and RC pipe, inlets, manholes, sewers, box
culverts, sidewalks, driveways, riprap, curb and gutter, concrete bridge railing, concrete median barrier, etc.
❑ Painting - includes painting of structural steel and concrete structures
❑ Professional Services - includes consulting engineers, architects, and surveyors
❑ Rest Areas - includes steel, masonry or wood fabrication and erection, electrical wiring, plumbing, etc.
❑ Traffic Control Devices - includes traffic signals, signs, barricades, pavement markers, buttons, edge lines,
striping, etc.
❑ Underground and Utility Work - includes PVC pipe, underground conduit, utility telephone lines, etc.
❑ Miscellaneous. Please specify.
❑ Banks owned and controlled by disadvantaged individuals.
f] Aviation. Please specify.
❑ Public Transportation. Please specify.
Form 2099 (Rev, 02/10)
Page 30 of 31
DBE UNIFORM CERTIFICATION APPLICATION SUPPORTING DOCUMENTS CHECKLIST
In order to coinplete your application for DBE certification, you must attach copies of all of the following
documents as they apply to you and your firm.
All Applicants
❑ Work experience resumes (include places of ownership/employment with corresponding dates), for all owners and
officers of your firm
❑ Personal Financial Statement (form available with this application)
❑ Personal tax returns for the past three years, if applicable, for each owner claiming disadvantaged status
❑ Your firm's tax returns (gross receipts) and all related schedules for the past three years
❑ Documented proof of contributions used to acquire ownership for each owner (e.g., both sales of cancelled checks)
❑ Your firm's signed loan agreements, security agreements, and bonding forms
❑ Descriptions of all real estate (including office/storage space, etc.) owned/leased by your firm and
documented proof of ownership/signed leases
❑ List of equipment leased and signed lease agreements
❑ List of construction equipment and/or vehicles owned and titles/proof of ownership
❑ Documented proof of any transfers of assets to/from your firm and/or to/from any of its owners over the past two
years
❑ Year-end balance sheets and income statements for the past three years (or life offirm, if less than three ,years); a new
business must provide a current balance sheet
❑ All relevant licenses, license renewal forms, permits, and haul authority forms
❑ DBE and SBA 8(a) or SDB certifications, denials, and/or decertifications, if applicable
❑ Bank authorization and signatory cards
❑ Schedule of salaries (or other compensation or remuneration) paid to all officers, managers, owners, and/or directors
of the firm
❑ Trust agreements held by any owner claiming disadvantaged status, if any
Partnership or Joint Venture
❑ Original and any amended Partnership or Joint Venture Agreements
Corporation or LLC
❑ Official Articles of Incorporation (signed by the state official)
❑ Both sides of all corporate stock certificates and your firm's stock transfer ledger
❑ Shareholders' Agreement
❑ Minutes of all stockholders and board of directors meetings
❑ Corporate by-laws and any amendments
❑ Corporate bank resolution and bank signature cards
❑ Official Certificate of Formation and Operating Agreement with any amendments (for LLCs)
Trucking Company
El Documented proof of ownership of the company
0 Insurance agreements for each truck owned or operated by your firm
❑ Title(s) and registration certificate(s) for each truck owned or operated by your firm
❑ List of U.S. DOT numbers for each truck owned or operated by your firm
pular Dealer
❑ Proof of warehouse ownership or lease
❑ List of product lines carried
❑ List of distribution equipment owned and/or leased
NOTE: The specific state UCP to which you are applying may have additional required documents that you must also supply with
your application. Contact the appropriate certifying agency to which you are applying to find out if more is required.
Form 2099 (Rev, 02110)
Page 31 of 31
Texas Unified Certification Program (TUCP) Participating Entities
DBE certifications through the TUCP are valid at the following entities:
Airports:
Abilene Regional Airport
Austin -Bergstrom International Airport
Corpus Christi International Airport
Dallas -Fort Worth International Airport
Del Rio International Airport
Easterwood Field (Texas A & M)
Gregg County Airport — Longview
Houston Airport System
Killeen Municipal Airport
Lubbock Preston Smith International Airport
Cities:
City of Amarillo
City of Arlington
City of Austin
City of Brownsville
City of Corpus Christi
City of Dallas
City of Denton
City of Desoto
Transit:
City of El Paso
City of Ft. Worth
City of Garland
City of Grand Prairie
City of Houston
City of Lewisville
City of Longview
City of McAllen
Beaumont Municipal Transit
Brownsville Urban System
Capital Metropolitan Transportation Authority - Austin
Central Texas Council of Governments (CTCOG) - Transit - Belton
City of Galveston - Island Transit
Corpus Christi Regional Transportation Authority (CCRTA)
Dallas Area Rapid Transit (DART)
Fort Worth Transportation Authority
Golden Crescent RPC - Transit - Victoria
Hill Country Transit District - San Saba
Lower Rio Grande Valley Development Council - Transit - McAllen
Lubbock Citybus System
Metropolitan Transit Authority of Houston
Texoma Council of Governments - Transit - Sherman
The Mass Transit Department of the City of El Paso (Sun Metro)
VIA Metropolitan Transit Authority - San Antonio
Waco Transit System
Other:
McAllen Miller International Airport
Midland International Airport
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ROUND ROCK, TEXAS
PURPOSE. PASSION. PROSPERITY
City Council Agenda Summary Sheet
Agenda Item No. 10A1.
Consider a resolution adopting the City's "Fiscal Year 2011 Disadvantaged Business
Agenda Caption: Enterprise Program."
Meeting Date: July 22, 2010
Department: Public Works Programs Planning and Administration
Staff Person making presentation: Tom Word, P.E.
Chief of Public Works Operations
Item Summary:
The Federal Transit Administration (FTA) has granted the City pre -award authority under two Letters of No Prejudice
dated January 23, 2007 and August 26, 2009. Pre -award authority allows the City to incur costs as a local match for
future federal funds. During FY 2011, the City of Round Rock expects to award more than $250,000 in contracts
utilizing the pre -award authority. As a result, the City is required to maintain its Disadvantaged Business Enterprise
(DBE) program in accordance with regulations of the U.S. Department of Transportation (DOT), 49 Code of Federal
Regulation Part 26.
The DBE program encourages minority-owned and women -owned business enterprises to participate in government
contracts by establishing DBE participation goals, ensuring DBE firms can compete fairly for federally funded
transportation -related projects and assisting DBE firms in competing outside the DBE Program. The City's FY 2011
program establishes a DBE participation goal of 22% for approximately $4,410,000 in contracts.
Presentations were made to local Chambers of Commerce, including those whose main focus is helping
disadvantaged businesses. The presentations included what qualifies a firm as a DBE, information about the DBE
Program, requirements for participation, certification agencies and the City's program.
The City also accepted Public Comments for 45 days beginning June 1, 2010.
Strategic Plan Relevance:
Mobility and Connectivity Strategic Initiative
2060 Vision: Residents and visitors will have alternative choices for transportation including public transportation
options, pedestrian/biking options and personal vehicle.
Cost: N/A
Source of Funds: N/A
Date of Public Hearing (if required): N/A
Recommended Action: Adoption of the FY 2011 DBE Program