contract number r -35611-a dbe affirmative action ... · contract number r -35611-a contract bid...

41
Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby certify that it is the intention of my company to affirmatively seek out and consider certified DBEs to participate in this contract as subcontractors, lessors, or suppliers of materials or services. I understand and agree that all subcontracting or leasing in connection with this contract, whether undertaken prior to or subsequent to award of contract, will be in accordance with the requirements for the Disadvantaged Business Enterprise (DBE) Program. The applicable requirements are included in the Standard Specifications and the Special Provisions in the Contract Information Book for this contract. I understand and agree that no subcontracting will be approved or commenced until the Department has reviewed and approved the affirmative actions taken by my company or me. I understand that utilization of certified DBEs is in addition to all other equal employment opportunity requirements of this contract. I acknowledge that this certification is to be made an integral part of this contract. I understand and agree that the submission of a blank certification shall cause my bid to be rejected. I hereby certify that contact has been made with the firms listed in this certification, and that I have confirmed that these firms are certified by the State of Indiana as DBEs. (For listing of DBE certified firms, see www.in.gov/indot/2576.htm and click on DBE Public Search.) If my company becomes the Contractor, the certified DBEs listed below have tentatively agreed to perform the corresponding services as part of this contract's DBE goal ("race/gender conscious" DBE participation). If a portion of a line item is used to satisfy the goal, the full dollar amount of the item will be considered as race conscious. I have also listed the certified DBEs that have tentatively agreed to perform the corresponding services listed below beyond what is necessary to meet the contract’s DBE goal ("race/gender neutral" DBE participation). I understand that neither my company nor I will be penalized for failure to achieve the dollar amounts listed beyond the contract goal. After contract award, any change to the firms listed as DBE SUBCONTRACTORS AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior approval by INDOT’s Economic Opportunity Section, Central Office. ------------------------------------------------------------------------------- CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION AND ADDRESS ACTUAL DOLLAR AMOUNT PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE ------------------------------------------------------------------------------- DBEW C A FULKERSON LLC Subcontractor Race Conscious 1650 QUARRY ROAD , CORYDON, IN 47112 25-31, 35 Landscaping 118,142.70 -------------------------------------------------------------------------------- Check: 82C279F3 Page 12

Upload: others

Post on 25-Sep-2020

6 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -35611-A

Contract Bid Amount $827,000.00

DBE Goal 14.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW C A FULKERSON LLC Subcontractor Race Conscious

1650 QUARRY ROAD , CORYDON, IN 47112

25-31, 35 Landscaping 118,142.70

--------------------------------------------------------------------------------

Check: 82C279F3 Page 12

Page 2: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 14.29% or $ 118142.70

Required: 14.00% or $ 115780.00

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Gohmann Construction Inc

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 82C279F3 Page 13

Page 3: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -34204-A

Contract Bid Amount $664,382.71

DBE Goal 10.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW EARTH IMAGES INC Subcontractor Race Conscious

3471 WEST COUNTY LINE ROAD P O BOX 267 , GREENWOOD, IN 46142

24,29,34 mulch & plantings 66,529.20

--------------------------------------------------------------------------------

Check: 0E9AB5B7 Page 12

Page 4: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 10.01% or $ 66529.20

Required: 10.00% or $ 66438.27

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Morphey Construction, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 0E9AB5B7 Page 13

Page 5: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -29729-A

Contract Bid Amount $1,867,524.57

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW C-TECH CORPORATION INC Subcontractor Race Conscious

5300 W 100 N , BOGGSTOWN, IN 46110

17,19,20,48-51,53,54,57,59 52,274.32

--------------------------------------------------------------------------------

Check: B8F3B90B Page 16

Page 6: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -29729-A

Contract Bid Amount $1,867,524.57

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW TRAFFIC CONTROL SPECIALISTS INC Subcontractor Race Conscious

301 W HAMILTON DRIVE , KNOX, IN 46534

56,77-81,82(P),83,87,88,91 80,722.18

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 7.12% or $ 132996.50

Required: 7.00% or $ 130726.72

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Superior Construction Co., Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: B8F3B90B Page 17

Page 7: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-35322-A

Contract Bid Amount $1,122,986.11

DBE Goal 8.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW DIAMOND TRUCKING INC Lease Race Conscious

2653 S 400 W , PERU, IN 46970

18 Hauling (partial) 90,757.00

--------------------------------------------------------------------------------

Check: 8843BE25 Page 13

Page 8: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 8.08% or $ 90757.00

Required: 8.00% or $ 89838.89

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: E & B Paving, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 8843BE25 Page 14

Page 9: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby
Page 10: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby
Page 11: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-35314-A

Contract Bid Amount $1,439,735.60

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW INDIANA SIGN & BARRICADE INC Subcontractor Race Conscious

5240 E 25TH ST , INDIANAPOLIS, IN 46218

7,34-43,46,51-56 (Traffic control & pavement markings) 101,877.92

--------------------------------------------------------------------------------

Check: 41166731 Page 12

Page 12: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 7.08% or $ 101877.92

Required: 7.00% or $ 100781.49

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: American Contracting & Services, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 41166731 Page 13

Page 13: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-31410-A

Contract Bid Amount $840,139.18

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW INDIANA SIGN & BARRICADE INC Subcontractor Race Conscious

5240 E 25TH ST , INDIANAPOLIS, IN 46218

11(p),36,37,39,40(p),46,47,48,49,50,51,52; pavement markings 36,601.70

--------------------------------------------------------------------------------

Check: A879227A Page 12

Page 14: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-31410-A

Contract Bid Amount $840,139.18

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW CMG TRUCKING INC Lease Race Conscious

7050 SOUTH COUNTY ROAD 700 , DALEVILLE, IN 47334

17(p),18(p),20(p),23(p); hauling 22,450.05

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 7.03% or $ 59051.75

Required: 7.00% or $ 58809.74

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: E & B Paving, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: A879227A Page 13

Page 15: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-31340-A

Contract Bid Amount $1,274,075.40

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW KAREN HAAN INC Subcontractor Race Conscious

1825 S HADLEY ROAD , FORT WAYNE, IN 46804

34, 37, 38 signs 2,984.00

--------------------------------------------------------------------------------

Check: 46635CEE Page 12

Page 16: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-31340-A

Contract Bid Amount $1,274,075.40

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW STATEWIDE TRUCKING INC Lease Race Conscious

7020 ARDMORE AVE P O BOX 9249 , FORT WAYNE, IN 46809

partial haul 14-18, 20., 28 87,000.03

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 7.06% or $ 89984.03

Required: 7.00% or $ 89185.28

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 798.72

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Brooks Construction Company, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 46635CEE Page 13

Page 17: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -31067-A

Contract Bid Amount $4,137,945.00

DBE Goal 5.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW INDIANA SIGN & BARRICADE INC Subcontractor Race Conscious

5240 E 25TH ST , INDIANAPOLIS, IN 46218

10,38-49 MOB & DEMOB, SIGNS, PAVEMENT MARKINGS 110,088.25

--------------------------------------------------------------------------------

Check: 6301AF68 Page 12

Page 18: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -31067-A

Contract Bid Amount $4,137,945.00

DBE Goal 5.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW M A S MARKERS INC Subcontractor Race Conscious

1625 S 400 E , LEBANON, IN 46052

10,51 MOB & DEMOB, SNOWPLOWABLE RAISED PAVEMENT MARKINGS 36,725.30

DBEW STARNES TRUCKING INC Lease Race Conscious

1539 S 100W , PRINCTON, IN 47670

24,16 HAULING 60,538.75

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 5.01% or $ 207352.30

Required: 5.00% or $ 206897.25

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Gohmann Construction Inc

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 6301AF68 Page 13

Page 19: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby
Page 20: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby
Page 21: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -30320-A

Contract Bid Amount $775,000.00

DBE Goal 12.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBE INDIANA TRAFFIC SERVICES LLC Subcontractor Race Conscious

3867 NORTH COMMERCIAL PARKWAY , GREENFIELD, IN 46140

Item 8-Partial, 39-40,43-44,46-47,51-62,66 / Pavement Markings 46,122.00

--------------------------------------------------------------------------------

Check: 7C2605B1 Page 13

Page 22: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -30320-A

Contract Bid Amount $775,000.00

DBE Goal 12.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW K & S MARKERS INC Subcontractor Race Conscious

2189 N 600 W , THORNTOWN, IN 46071

Items 63-65, Partial-8 / SPRPM 5,790.00

DBEW ELLINGTON TRUCKING LLC Lease Race Conscious

1829 BLANKENSHIP DRIVE , INDIANAPOLIS, IN 46217

Items 15, 18 Partial / Hauling 42,000.00

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 12.12% or $ 93912.00

Required: 12.00% or $ 93000.00

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Calumet Civil Contractors, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 7C2605B1 Page 14

Page 23: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -28946-A

Contract Bid Amount $3,983,147.00

DBE Goal 14.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW EARTH IMAGES INC Subcontractor Race Conscious

3471 WEST COUNTY LINE ROAD P O BOX 267 , GREENWOOD, IN 46142

24, 25, 60-63, 65 Temp Mulching & Silt Fence, Seed & Sod 43,908.85

--------------------------------------------------------------------------------

Check: 0627E448 Page 24

Page 24: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -28946-A

Contract Bid Amount $3,983,147.00

DBE Goal 14.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW INDIANA SIGN & BARRICADE INC Subcontractor Race Conscious

5240 E 25TH ST , INDIANAPOLIS, IN 46218

11p, 134-139, 140p, 141, 164-173 Const Sign, Barricade, Line, TM 83,256.75

DBEW C-TECH CORPORATION INC Subcontractor Race Conscious

5300 W 100 N , BOGGSTOWN, IN 46110

58, 59, 142p, ROW Marker, Monument B, Temp Traffic Barrier 20,355.00

DBEM STEPHEN J CHRISTIAN & ASSOCIATE Subcontractor Race Conscious

9102 N MERIDIAN STREET SUITE 200 , INDIANAPOLIS, IN 46260

1 Construction Engineering 29,210.00

DBEW HOOSIER COMPANY INC Subcontractor Race Conscious

5421 W 86TH STREET P O BOX 681064 , INDIANAPOLIS, IN 46268

11p, 140p, 143-163 Signal, MOT 45,482.06

DBE ENGEL MAN TRUCKING INC Lease Race Conscious

7408 N TREE FARM ROAD , SOLSBERRY, IN 47459

14, 20, 23, 26, 28, 32, 36-41, 55, 90-96, 101-107, 118-131 Truck 250,000.00

DBEW 3D COMPANY INC Subcontractor Race Conscious

3200 E CR 350N , MUNCIE, IN 47303

11p, 89, 100, 108-110 Video Inspection 88,189.20

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 14.07% or $ 560401.86

Required: 14.00% or $ 557640.58

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Dave O'Mara Contractor, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 0627E448 Page 25

Page 25: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -28794-A

Contract Bid Amount $297,309.26

DBE Goal 9.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW C-TECH CORPORATION INC Subcontractor Race Conscious

5300 W 100 N , BOGGSTOWN, IN 46110

14, 30-34, 52, 53 Guardrail, Fence Remove, Sign Sheet 27,355.00

--------------------------------------------------------------------------------

Check: 14708845 Page 12

Page 26: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 9.20% or $ 27355.00

Required: 9.00% or $ 26757.83

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 500.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Dave O'Mara Contractor, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 14708845 Page 13

Page 27: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby
Page 28: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number B -35423-A

Contract Bid Amount $2,305,948.00

DBE Goal 5.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBE INDIANA TRAFFIC SERVICES LLC Subcontractor Race Conscious

3867 NORTH COMMERCIAL PARKWAY , GREENFIELD, IN 46140

5;99;100;101;102;103;104;105;108;112;113;114;115;116;117;118 & 1 26,853.90

--------------------------------------------------------------------------------

Check: F5EE5C94 Page 19

Page 29: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number B -35423-A

Contract Bid Amount $2,305,948.00

DBE Goal 5.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW C-TECH CORPORATION INC Subcontractor Race Conscious

5300 W 100 N , BOGGSTOWN, IN 46110

43;44;45;46;47;48;49;50;55;56;83; & 107 67,411.08

DBEW EARTH IMAGES INC Subcontractor Race Conscious

3471 WEST COUNTY LINE ROAD P O BOX 267 , GREENWOOD, IN 46142

19; 20; 22; 60; 61; & 62 11,034.24

DBEW HOOSIER COMPANY INC Subcontractor Race Conscious

5421 W 86TH STREET P O BOX 681064 , INDIANAPOLIS, IN 46268

111; Conduit 14,623.99

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 5.20% or $ 119923.21

Required: 5.00% or $ 115297.40

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Beaty Construction, Inc

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: F5EE5C94 Page 20

Page 30: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number B -30982-A

Contract Bid Amount $799,025.04

DBE Goal 10.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW C L S INDUSTRIES INC Subcontractor Race Conscious

3960 W STATE ROAD 60 P O BOX 138 , SALEM, IN 47167

16SignRmv., 18GrdrlEndtrtRmv., 44-47Guardrail Components 26,549.04

--------------------------------------------------------------------------------

Check: 4FF373EB Page 15

Page 31: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number B -30982-A

Contract Bid Amount $799,025.04

DBE Goal 10.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW C L S INDUSTRIES INC Subcontractor Race Conscious

3960 W STATE ROAD 60 P O BOX 138 , SALEM, IN 47167

74-79TmpSgnsMrkng,80Maint.trffc(P),81Brricd, 82TmpBrrir(P),83-88 22,407.92

DBEM CIRCLE CITY REBAR LLC DBE Supplier Manufacturer Race Conscious

4002 INDUSTRIAL BLVD , INDIANPOLIS, IN 46254

64 Rebar (P) 55,342.57

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 13.05% or $ 104299.53

Required: 10.00% or $ 79902.50

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Weddle Bros. Highway Group, LLC.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 4FF373EB Page 16

Page 32: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -31590-A

Contract Bid Amount $421,260.30

DBE Goal 10.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBE INDIANA TRAFFIC SERVICES LLC Subcontractor Race Conscious

3867 NORTH COMMERCIAL PARKWAY , GREENFIELD, IN 46140

72-75, 77, 78, 83-85, 87 Const Sign, Detour Marker, Barricade, L 9,640.00

--------------------------------------------------------------------------------

Check: 511301F8 Page 15

Page 33: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -31590-A

Contract Bid Amount $421,260.30

DBE Goal 10.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW C-TECH CORPORATION INC Subcontractor Race Conscious

5300 W 100 N , BOGGSTOWN, IN 46110

34, 36-40, 46-48, 79, 81, 82 Guardrail, ROW Marker, Monument, Si 22,060.75

DBEW EARTH IMAGES INC Subcontractor Race Conscious

3471 WEST COUNTY LINE ROAD P O BOX 267 , GREENWOOD, IN 46142

16, 17, 21, 51-56 Temp Mulch, Silt Fence & Seed Mixture, Sod, Er 13,577.35

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 10.75% or $ 45278.10

Required: 10.00% or $ 42126.03

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 3,000.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Dave O'Mara Contractor, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 511301F8 Page 16

Page 34: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -33088-A

Contract Bid Amount $1,097,324.88

DBE Goal 14.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW HAWK ENTERPRISES INC Subcontractor Race Conscious

1850 EAST NORTH STREET , CROWN POINT, IN 46307

104-108 TRAFFIC CONTROL SIGN INSTALLATION 3,076.00

--------------------------------------------------------------------------------

Check: CDEAD7A6 Page 19

Page 35: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -33088-A

Contract Bid Amount $1,097,324.88

DBE Goal 14.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW LAPORTE CONSTRUCTION COMPANY IN Subcontractor Race Conscious

4999 S US HIGHWAY 35 P O BOX 577 , LAPORTE, IN 46352

27, 39, 66, 67, 78, 89, 90 BLOCK WALL/SMALL STRUCTURES 82,162.00

DBEW TRAFFIC CONTROL SPECIALISTS INC Subcontractor Race Conscious

301 W HAMILTON DRIVE , KNOX, IN 46534

9, 91-103, 109-119, TRAFFIC CONTROL SIGN INSTALLATION PAVEMENT M 38,935.48

DBEW 3D COMPANY INC Subcontractor Race Conscious

3200 E CR 350N , MUNCIE, IN 47303

74 VIDEO INSPECTION FOR PIPE 1,999.50

DBEM C LEE CONSTRUCTION SERVICES INC Lease Race Conscious

1200 W. MAIN ST P O BOX 618 , GRIFFITH, IN 46319

10, 18, 21-25, 28-31 HAULING 12,750.00

DBEW DYER VAULT COMPANY INC DBE Supplier Manufacturer Race Conscious

1750 SHEFFIELD AVE , DYER, IN 46311

81-88 SUPPLY MATERIAL FOR CATCH BASIN, MANHOLE, INLETS 18,000.00

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 14.30% or $ 156922.98

Required: 14.00% or $ 153625.48

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Walsh & Kelly, Inc.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: CDEAD7A6 Page 20

Page 36: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number R -35360-A

Contract Bid Amount $392,800.00

DBE Goal 5.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW INTERNATIONAL PIPE CONSULTANTS DBE Supplier Manufacturer Race Conscious

3716 W CR 750 N , ORLEANS, IN 47452

24 Liner Pipe 31,567.40

--------------------------------------------------------------------------------

Check: ED0221AB Page 9

Page 37: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 8.04% or $ 31567.40

Required: 5.00% or $ 19640.00

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Temple and Temple Excavating and Pavin

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: ED0221AB Page 10

Page 38: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-35313-A

Contract Bid Amount $454,749.96

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW COLUMBUS TRANSPORT INC Lease Race Conscious

5055 LONG ROAD SUITE A , COLUMBUS, IN 47203

Item #16 (Partial), Misc Hauling 12,000.00

--------------------------------------------------------------------------------

Check: 02ADB025 Page 11

Page 39: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-35313-A

Contract Bid Amount $454,749.96

DBE Goal 7.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBE INDIANA TRAFFIC SERVICES LLC Subcontractor Race Conscious

3867 NORTH COMMERCIAL PARKWAY , GREENFIELD, IN 46140

Item 25 & 26, 33-41, 44 & 45, Pavement Markings & Construction S 21,000.00

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 7.26% or $ 33000.00

Required: 7.00% or $ 31832.50

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: Milestone Contractors L.P.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 02ADB025 Page 12

Page 40: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-35329-A

Contract Bid Amount $1,610,870.00

DBE Goal 9.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

I do hereby certify that it is the intention of my company to affirmatively

seek out and consider certified DBEs to participate in this contract as

subcontractors, lessors, or suppliers of materials or services.

I understand and agree that all subcontracting or leasing in connection with

this contract, whether undertaken prior to or subsequent to award of contract,

will be in accordance with the requirements for the Disadvantaged Business

Enterprise (DBE) Program. The applicable requirements are included in the

Standard Specifications and the Special Provisions in the Contract Information

Book for this contract. I understand and agree that no subcontracting will be

approved or commenced until the Department has reviewed and approved the

affirmative actions taken by my company or me.

I understand that utilization of certified DBEs is in addition to all other

equal employment opportunity requirements of this contract.

I acknowledge that this certification is to be made an integral part of this

contract.

I understand and agree that the submission of a blank certification shall cause

my bid to be rejected.

I hereby certify that contact has been made with the firms listed in this

certification, and that I have confirmed that these firms are certified by the

State of Indiana as DBEs. (For listing of DBE certified firms, see

www.in.gov/indot/2576.htm and click on DBE Public Search.)

If my company becomes the Contractor, the certified DBEs listed below have

tentatively agreed to perform the corresponding services as part of this

contract's DBE goal ("race/gender conscious" DBE participation). If a portion

of a line item is used to satisfy the goal, the full dollar amount of the item

will be considered as race conscious.

I have also listed the certified DBEs that have tentatively agreed to perform

the corresponding services listed below beyond what is necessary to meet the

contract’s DBE goal ("race/gender neutral" DBE participation). I understand

that neither my company nor I will be penalized for failure to achieve the

dollar amounts listed beyond the contract goal.

After contract award, any change to the firms listed as DBE SUBCONTRACTORS

AND LESSORS TO BE APPLIED TOWARD GOAL or DBE MATERIAL SUPPLIERS TO BE

APPLIED TOWARD GOAL in this Affirmative Action Certification must have prior

approval by INDOT’s Economic Opportunity Section, Central Office.

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEW INDIANA SIGN & BARRICADE INC Subcontractor Race Conscious

5240 E 25TH ST , INDIANAPOLIS, IN 46218

8(p),25-28,29(p),32-42,45 construction signs & pav't markings 115,075.75

--------------------------------------------------------------------------------

Check: 3EE32974 Page 11

Page 41: Contract Number R -35611-A DBE AFFIRMATIVE ACTION ... · Contract Number R -35611-A Contract Bid Amount $827,000.00 DBE Goal 14.00% DBE AFFIRMATIVE ACTION CERTIFICATION I do hereby

Contract Number RS-35329-A

Contract Bid Amount $1,610,870.00

DBE Goal 9.00%

DBE AFFIRMATIVE ACTION CERTIFICATION

-------------------------------------------------------------------------------

CERTIFICATION CODE AND DBE NAME USED AS PARTICIPATION

AND ADDRESS ACTUAL DOLLAR AMOUNT

PAY ITEM NUMBER AND SERVICE PLANNED TO BE PAID TO DBE

-------------------------------------------------------------------------------

DBEM NASH & SON TRUCKING COMPANY INC Lease Race Conscious

1608 S JEFFERSON , MUNCIE, IN 47302

15 hauling (p) 30,100.00

TOTAL DOLLAR AMOUNT CREDITED TOWARD DBE GOAL (RACE/GENDER CONSCIOUS):

Entered: 9.01% or $ 145175.75

Required: 9.00% or $ 144978.30

<GOAL MET>

TOTAL DOLLAR AMOUNT OF VOLUNTARY DBE WORK ANTICIPATED OVER DBE GOAL

(RACE/GENDER NEUTRAL): $ 0.00

Please Note: Credit for utilization of a DBE material supplier depends on

whether the supplier is a manufacturer, regular dealer or broker.

The following credit will be counted toward the goal: Supplier

Manufacturer receives 100% credit, Supplier Regular Dealer receives

60% credit, and Supplier Broker receives fees and commissions only.

NAME OF COMPANY: E & B PAVING, INC.

BID DATE: 11-06-13

--------------------------------------------------------------------------------

Check: 3EE32974 Page 12