Specifications

WISCONSIN DEPARTMENT OF BID #268246 TRAFFIC DATA RECORDERS
TRANSPORTATION PAGE 20 OF 23
ATTACHMENT C
WisDOT MINORITY BUSINESS ENTERPRISE (MBE) PROGRAM
AWARENESS, COMPLIANCE & ACTION PLAN
Complete, sign, and include in your bid response.
Failure to complete this form as a component of your bid may result in rejection of your bid.
Our company/organization is a Wisconsin-certified Minority Business Enterprise (MBE)
 Yes
 No
Our company/organization is a minority business but has not yet received Wisconsin certification (please
provide details): _____________________________________________
 Yes
 No
We are aware of the WisDOT’s goal to spend at least 5% of their total annual purchasing dollars with state-
certified MBE firms.
 Yes
 No
We are aware that if awarded this contract/project our company/organization will provide monthly or
quarterly reports to WisDOT reporting all expenditure activity directed to MBE subcontractors or second-tier
MBE suppliers that directly relate to this contract. (Any non-certified minority businesses could be a potential
subcontractor/second-tier supplier--indicate these on your plan. WisDOT will work with those businesses for
possible certification.)
 Yes
 No
Subcontractors: Our company/organization intends to subcontract at least 5% dollar volume with certified
MBE firms listed below (names, addresses, telephone numbers):
 Yes
 No
Second-tier Suppliers: In addition to direct subcontracting efforts, your company/organization can help WisDOT achieve the 5%
goal by managing your second-tier minority purchases. Second-tier business refers to incidental business expenses your
company may spend with Wisconsin-certified MBE firms as it pursues the normal course of business supplying the WisDOT-
contracted products or services. Here are some examples:
Percentage of your office supplies specifically used during the course of this contract/project.
Percentage of uniform costs for staff performing this contract/project.
If you travel to perform this contract/project, you could use a state-certified MBE travel agency and report that
expense.
Percentage of facilities maintenance services for facility(ies) directly used by your staff during the course of this
contract/project.
These second-tier expenses can only be reported to the extent that they directly relate to your business with WisDOT. The
percentage of the expense you can report is determined by the amount of your WisDOT sales as it relates to your total sales
volume. Per the terms of your contract, you should actively pursue directing business towards these types of companies, and
report your efforts in this regard on a monthly basis.
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In paragraph form, describe your company/organization’s commitment/action plan with regard to the planned use of state-
certified MBE businesses in subcontracting efforts, as well as developing MBE second-tier suppliers. Please list your specific
commitments (attach sheet, if necessary).
SIGNATURE: ______________________________________ DATE: __________________________________
PRINTED NAME & TITLE: ____________________________________________________________________
COMPANY: ________________________________________PHONE NUMBER: ________________________