NOTICE TO DESIGN/OTHER  CONSULTANTS 
Bidder’s List  of Quoters Collection Form 
The term “Quoter” shall include subcontractors and suppliers of materials with whom the Contractor contracts directly. 
Project Name: ___________________________________________________________________    Project No.: ___________________________________________________________ 
Bidder/Contractor Name: _______________________________  Address: ___________________________________  Telephone#: ________________  Email:___________________ 
LISTING OF QUOTERS 
FIRM NAME, ADDRESS 
 PHONE NUMBER 
DESCRIPTION OF WORK 
Dollar Amt. of Bid 
Proposal 
Will Firm 
Be Used 
DBE OR NON-
DBE STATUS 
AGE OF FRIM 
ANNUAL GROSS 
RECEIPTS 
Name: ______________________________ 
Address:____________________________ 
_________________________________ 
Phone No.: __________________________ 
Email________________________________ 
___  Yes 
___  No 
 DBE 
  NON-DBE 
___ Less than 1 year 
___ 1 – 3 years 
___ 4 – 7 years 
___ 8 – 10 years 
___ more than 10 years 
 ___ Less than $500K  
 ___ $500K - $1M 
 ___ $1-2M 
 ___ $2-5M 
 ___ Greater than $5M 
Name: ______________________________ 
Address:_____________________________ 
_________________________________ 
Phone No.: __________________________ 
Email________________________________ 
___  Yes 
___  No 
 DBE 
 NON-DBE 
___ Less than 1 year 
___ 1 – 3 years 
___ 4 – 7 years 
___ 8 – 10 years 
___ more than 10 years 
  ___ Less than $500K  
 ___ $500K - $1M 
 ___ $1-2M 
 ___ $2-5M 
 ___ Greater than $5M 
APPENDIX  C 
FORM BLDC  /  DBE C 
Page 1 of 2 
In accordance with 49 CFR Part 26, the Department of Public Works (DPW) will establish it Annual DBE goal using a Bidders List.  The Bidders List will be a compilation 
of all quotes received by the Design/Other Consultants during the advertising period.  The Bidders List will be used to determine the relative availability of DBEs. 
At the time the bid is submitted to the Contracting Officer/DPW, the Design/Other Consultants shall list, on Form BLCC, the quotes received for the project, using 
additional sheets as necessary.  The listing shall include EACH quoter’s name, address, telephone number, age of firm, annual gross receipts of the firm and whether 
the quoter is a Virgin Islands certified DBE.  FAILURE TO COMPLY WITH THIS REQUIREMENT SHALL RENDER A BID NON-RESPONSIVE AND THE BID SHALL BE 
REJECTED.  
LISTING OF QUOTERS  (attach additional sheets if necessary) 
The undersigned hereby declares that the information set forth on this form is current, complete and accurate. 
Authorized Signature: ________________________________________ 
 Date:  _____________________ 
Printed Name: _____________________________________________ 
 Title: ______________________ 
FIRM NAME, ADDRESS 
 PHONE NUMBER 
DESCRIPTION OF WORK 
Dollar Amt. of Bid 
Proposal 
Will Firm 
Be Used 
DBE OR NON-
DBE STATUS 
AGE OF FRIM 
ANNUAL GROSS 
RECEIPTS 
Name: _________________________________ 
Address:________________________________ 
_________________________________ 
Phone No.: ______________________________ 
Email____________________________________ 
___  Yes 
___  No 
 DBE 
 NON-DBE 
___ Less than 1 year 
___ 1 – 3 years 
___ 4 – 7 years 
___ 8 – 10 years 
___ more than 10 years 
 ___ Less than $500K  
 ___ $500K - $1M 
 ___ $1-2M 
 ___ $2-5M 
 ___ Greater than $5M 
Name: __________________________________ 
Address:_________________________________ 
_________________________________ 
Phone No.: _______________________________ 
Email____________________________________ 
___  Yes 
___  No 
 DBE 
 NON-DBE 
___ Less than 1 year 
___ 1 – 3 years 
___ 4 – 7 years 
___ 8 – 10 years 
___ more than 10 years 
 ___ Less than $500K  
 ___ $500K - $1M 
 ___ $1-2M 
 ___ $2-5M 
 ___ Greater than $5M 
Name: ___________________________________ 
Address:_________________________________ 
_________________________________ 
Phone No.: _______________________________ 
Email_____________________________________ 
___  Yes 
___  No 
 DBE 
 NON-DBE 
___ Less than 1 year 
___ 1 – 3 years 
___ 4 – 7 years 
___ 8 – 10 years 
___ more than 10 years 
  ___ Less than $500K  
 ___ $500K - $1M 
 ___ $1-2M 
 ___ $2-5M 
 ___ Greater than $5M