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Request for Proposals Bulletin: <br />Project: School ?one flashin y Beacons o <br />South Bend, Indiana Des # 1 01240 in LaPorte District <br />AFFIRMATIVE ACTION CERTIFICATION <br />I hereby certify that my company intends to affirmatively seek out and consider Disadvantaged Business <br />Enterprises (DBEs) certified in the State of Indiana to participate as part of this proposal. I acknowledge <br />that this certification is to be made an integral part of this proposal. I understand and agree that the <br />submission of a blank certification may cause the proposal to be rejected. I certify that I have consulted <br />the following DBE website to confirm that the firms listed below are currently certified DBEs: <br />latt,Ia a!Bs tlrla am i, eraWn g .vfp. cdgu 5 J} PLOY EEIRP/c/SOI APPS MWBE.SOIw DBE CERT GBL`?& <br />I certify that I have contacted the certified DBEs listed below, and if my company becomes the <br />CONSULTANT, these DBEs have tentatively agreed to perform the services as indicated. I understand <br />that neither my company nor I will be penalized for DBE utilization that exceeds the goal. After contract <br />award, any change to the firms listed in this Affirmative Action Certification to be applied toward the <br />DBE goal must have prior approval by INDOT's Economic Opportunity Division. <br />SUBCONSULTANTS <br />DBE SUBCONSULTANTS TO BE APPLIED TOWARD GOAL <br />Certified DBE Name Service Planned Estimated percentage to be paidto DBE* <br />VS Engineering 6.1 3% <br />4275 N. High School Rd. <br />Indianapolis, IN 46254 <br />317.293.3542 <br />DBE SUBCONSULTANTS TO BE USED BEYOND GOAL <br />Certified DBE Name Service Planned Estimated percenta2c to be oaad to DBE* <br />..... <br />___ <br />L.. .............................. <br />..... _ .... ..... <br />....... <br />Estimated Total Percentage Credited toward DBE Goal: 3% <br />Estimated Percentage of Voluntary DBE Work Anticipated over DBE Goal: 4% <br />Name of Company: The Troyer Group, Inc. <br />By: Date: 01 /22/2019 <br />*It is understood that these individual firm percentages and dollar amounts are estimates only and that amounts paid may be <br />greater or less as a result of negotiation of the contract scope of work. My firm will use good faith efforts to meet the overall <br />DBE goal through the use of these or other certified and approved DBE firms. <br />