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COMMITMENT TO SUBCONTRACT TO DBE
Wisconsin Department of Transportation
DT1506 1/2021 s.84.06(2) Wis. Stats.
Project ID:
Proposal #
Prime Contractor:
County:
Letting Date:
This contract requires that a specified percentage of the work be subcontracted to a
disadvantaged business enterprise and that this information be submitted as
described in ASP-3. The submittal of this form with the bid proposal constitutes your
DBE commitment. Include Attachment A for DBEs included on commitment.
Total $ Value of
Prime Contract:
$
DBE Contract Goal:
%
DBE Goal Achieved:
%
c
This form must be completed and returned for this proposal. See page 2 for instructions.
1. DBE Firm
2. Work or Items to be subcontracted
3. Supplier
Y/N
4. Trucking Only
5. DBE Full
Subcontract $
6. DBE Amount
for Credit $
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
O#
L#
$
$
Government Use Only
Approved Amounts
Prime Representative Signature & Date
DBE Office Signature & Date Approved
A =
$
%
V =
$
%
Total =
$
%
Signature:
Date:
Good faith effort approved: Yes No
0.00
0.00
0.00
Clear
Instructions for completing Commitment to Subcontract to DBE form DT1506:
In accordance with DBE Regulation (49 CFR part 26), WisDOT tracks assigned goal attainment (DBE Conscious) and
voluntary utilization of DBE firms (DBE Neutral). DBE participation reported on this form will be used to periodically adjust
(DBE Conscious and DBE Neutral) components of WisDOT's overall annual DBE goal.
1. Complete all of the fields in the top portion of the form. The “DBE Goal Achieved” field will auto-populate
2. Enter the name of each DBE firm used in the commitment for this proposal in Column 1
3. Enter the type of work or items to be subcontracted or supplies purchased in Column 2
4. Enter Y for “yes” or N for “no” in Column 3 indicating if the DBE is a Supplier
5. Enter the number of DBE-Owned (O) and DBE-Owned-Leased (L) trucks in Column 4 for DBE trucking firm listed in
Column 1
6. Fill in the full amount of the DBE subcontract in column 5
7. Fill in the amount of the DBE subcontract that is eligible for DBE credit in Column 6 *DO NOT ENTER
SIGNATURE & SAVE UNTIL YOUR FORM IS COMPLETE. YOU CANNOT EDIT AFTER SIGNING & SAVING*
Credit for Supplies
The department will give 100% credit toward the DBE goal if the DBE is a manufacturer or fabricator of their materials or
supplies. The department will give 60% credit or brokerage fee set by industry’s standard toward the DBE goal if the DBE
is only a supplier of these materials or supplies. Drop shipment by a supplier will earn a 10% DBE credit. It is the Prime
Contractor’s responsibility to use the UCP Directory to confirm that the DBE is considered a supplier or a manufacturer
before listing them on this form. WisDOT will adjust the credit, if required, when approving the form.
After completing the form, if it does not indicate that the DBE goal has been met, complete and submit Documentation of
Good Faith Efforts form (DT1202) with the bid. Supplemental GFE documentation must be submitted as described in
ASP-3.
Credit for Trucking
DBE crediting for the trucking industry is achieved in the following manner:
a. A minimum of one truck owned by the DBE must be used on the contract
b. 100% DBE credit is given for DBE-owned trucks and trucks leased from another DBE
c. Trucks leased by a DBE from non-DBE firms will be given DBE credit of 10% of the subcontract value
All trucks used for credit must be listed and approved on the DBE firm’s Schedule of Owned/Leased Vehicles for DBE
Credit and/or a WisDOT approved trucking utilization plan
It is the Prime Contractor’s and the DBE firm’s responsibility to ensure that utilization of trucks and the DBE credit earned
is in accordance with the above and will yield the subcontract dollar value listed on the Commitment to Subcontract to
DBE form.
Instructions for completing Attachment A form:
Section 26.53 (49 CFR part 26) requires written confirmation of participation from each DBE firm to be used on the
contract. Submit one copy of a completed Attachment A, Confirmation of Participation form, for each DBE firm to be used
on this contract. Each form must be signed by the Prime Contractor and the DBE firm specified on the form.
1. Complete all fields at the top of the form
2. Enter the total amount of the Subcontract Value AND the total amount of DBE Credit Value. These numbers may be
the same but pay special attention to supplies and trucking
3. For Prime Contractors Only: Complete all fields in this section and sign the form
4. For Participating DBE Firms Only: Complete all fields in this section and sign the form
5. For DBE trucking firms: Enter the number of trucks owned and leased as indicated in the table. These entries must
match with the information provided by your firm in the Schedule of Owned and Leased Trucks:
https://wisconsindot.gov/Pages/doing-bus/civil-rights/labornwage/trckng.aspx
*In the case that you do not have a signed Attachment A from a DBE at the time of bid, submit that DBE’s quote with the
bid and submit the signed Attachment A by 11:00 AM on the Wednesday following bid letting to: DBE_Alert@dot.wi.gov.
Identify: Proposal #, Let date, Prime Name, Attachment A on the subject line of the email.
If you have questions about filling out these forms, please contact OBOEC at (608) 267-3849.
COMMITMENT TO SUBCONTRACT TO DBE
ATTACHMENT A
CONFIRMATION OF PARTICIPATION
Project I.D.:
Proposal Number:
Letting Date:
Name of DBE Firm Participating in this Contract:
Name of the Prime/Subcontractor who hired the DBE Firm: (list all names of tiers if more than one)
Type of Work or Type of Material Supplied:
Total Subcontract Value:
Total DBE Credit Value:
# Owned Trucks
# Leased Trucks
# DBE-Owned Leased
Trucks
# Non-DBE-Owned
Leased Trucks
FOR PRIME CONTRACTORS ONLY:
I certify that I made arrangements with the participating
DBE firm to perform the type of work listed or supply the
material indicated above for the subcontract value listed
above.
Prime Contractor Representative’s Signature
Prime Contractor Representative’s Name (Print Name)
Prime Contractor (Print Company Name)
Date
FOR PARTICIPATING DBE FIRMS ONLY:
I certify that I made arrangements with the Prime
Contractor or the Hiring Contractor to perform the type of
work or supply the material indicated above for the
subcontract value listed above.
FOR DBE TRUCKING FIRMS ONLY:
I certify that I will utilize, for DBE credit, only trucks listed
on my WisDOT approved Schedule of Owned/Leased
Vehicles for DBE Credit form and I will be utilizing the
number of trucks as listed below.
Participating DBE Firm Representative’s Signature & Date
Participating DBE Firm Representative’s Name (Print Name)
Participating DBE Firm (Print Company Name)
DBE Firm’s Address:
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Completed 15 March 2021

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