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Please complete and mail or fax to. <br />Equal Opportunity Office <br />605 Suwannee St., MS 65 <br />Tallahassee, FL 32399-0450 <br />TELEPHONE: (850) 414-4747 <br />FAX: (850) 414-4879 <br />This information may also be included. in your bid or proposal package. <br />I <br />Prime Contractor/Consultant: <br />Address/%lephane Number tS <br />2 <br />Bid/Proposal Number: 2A � I.OZ(a <br />Quote Submitted MMNR: l • Z�� j4 <br />49 CFR Part 26.11 requires the Florida Department of Transportation to develop and maintain a "bid opportunity list." The <br />list is Intended to be a listing of all firms that are participating, or attempting to participate, on DOT assisted contracts. The <br />list must include all firms that bid on prime contracts, or bid or quote subcontracts <br />and materials supplies on DOT-assisted <br />projects, including both DBEs and non-DBEs. For consulting companies this list must include all subconsultants <br />contacting you and expressing an interest in teaming with you on a specific DOT <br />assisted project. Prime contractors and <br />consultants must provide information for Nos.1, 2, 3 and 4 and should provide any information they have available on <br />Numbers 5, 6, 7, and 8 for themselves, and their subcontractors and subconsultants_ <br />1. Federal Tax (D Nurrlbef: 0 - T* 6. ❑ DBE <br />8. Annual Gross Receipts <br />2. Firm Name{.0',$ .. Rr Nan-DBE <br />Less than $1 million <br />3. Phone: ")-72 . '1.t.3 ._ . <br />• Between $1 - $5 million <br />4. Address; <br />❑ Between $5 - $10 million <br />i <br />7. R 'Subcantractor <br />❑ Between $10 - $15 million <br />� <br />�J¢, r*, ,RPA ilk 4f. ❑ Subconsultant <br />❑ More than $15 million <br />5. 'Year Firm Established:O t3 <br />1. Federal Tax ID Number: Zlo 19Zj-ZZ 6. ❑ DBE <br />8. Annual Gross Receipts <br />, <br />2. Firm Name:;gJ�Kf1JV4y�tU.,,0 Non-DBE <br />❑ Less than $1 million <br />3. Phone: Z(,* 313x-AO%kC <br />0 Between $1 - $5 million <br />4. Address: <br />❑ Between $5 - $10 million <br />�% se T 7. Rr Subcontractor <br />❑ Between $10 - $15 million <br />fL - 3uR"t4 ❑ Subconsultant <br />❑ More than $15 million <br />5. Year Firm Established: 2,013!1 <br />1. Federal Tax ID Number: 6. ❑ DBE <br />8. Annual Gross Receipts <br />i <br />2. Firm Name: ❑ Non-DBE <br />❑ Less than $1 million <br />•' <br />3. Phone: <br />❑ Between $1 - $5 million <br />4. Address: <br />❑ Between $5 - $10 million <br />7, ❑ Subcontractor <br />❑ Between $10 - $16 million <br />❑ Subconsultant <br />❑ More than $15 million <br />5. Year Firm Established: <br />0047(1--9 <br />