Form 517014 0316Project NumberPrime ContractorDBE SubWork TypeType of Work ObservedDoes DBE onsite representative effectively manage the work YesNoIf No explainDoes DBE appear to have control over ID: 894289
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1 Form 517014 (03/16) DBE Commercially
Form 517014 (03/16) DBE Commercially Useful Function Checklist Project Number: Prime Contractor: DBE Sub - Work Type : Type of Work Observed: Does DBE on - site representative effectively manage the work Yes No If No, explain: Does DBE appear to have control over methods of work and equipment needed for their contract items? If No, explain: Yes No To your knowledge, has anyone other than the DBE’s personnel worked on the sub - contracted items? If Yes, explain: Yes No Has the DBE used their own, leased, or rented equipment for these contract items? Yes No If No, explain: Has the DBE used any of the prime contractor’s people or equipment? Yes No If Yes , explain: Does it appear that someone other than the DBE is furnishing material for the items the DBE is responsible for? If Yes, explain: Yes No Reviewer: Date: