Civil Rights Forms

All forms are listed on the page by type. Links to the sections are listed in the menu to the right. If you know the name or number of the form, you can use the quick links in the table below.

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ADA

• ADA Complaint Form
• ADA Reasonable Accommodation Request Form
• DOT&PF ADA Work Plan

Contract Compliance

• Chief Engineer's Directive re: CUF Forms
• DBE CUF Monitoring Report; 25A-298
• DBE CUF Verification; 25A-299
• Commercially Useful Function (CUF) Brochure
• 25A-301 Federal EEO Bid Conditions
• 25A-303 DOT&PF Monthly Employment Utilization Report
• 25A-304; EEO-1 Certification
• 25A-321A Contact Report;
• DBE Subcontractable Items
• 25A-325C DBE Utilization Report, Federal Aid
• 25A-326 Prime Contractor's Written DBE Commitment
• 25A-332A Summary of Good Faith Effort
• 25A-336 Instructions Summary of DBE Participation
• 25A-336 Summary of DBE Participation
• 25D-5 Subcontractor List
• 25D-6 Bidder's Registration Form - Must Be Submitted Each Year in January
• 25D-6 Consultant Registration; PSA DBE - Must Be Submitted Each Year in January
• 25D-55A Required Contract Provisions for Federal-Aid (FAA) Construction Contracts
• 25D-55H Required Contract Provisions for Federal-Aid (FHWA) Construction Contracts
• 25D-55T Required Contract Provisions for Federal-Aid (FHWA) Construction Contracts
• Contract Compliance Review (CCR)Checklist
• DBE Project Goal Setting
• FHWA-1391 Federal-aid Highway Construction Contractors Annual EEO Report
• Good Faith Effort Flow Chart
• Good Faith Effort Guidance
• Plan Holder Self Registration List Guide
• Prompt Pay
• Sample Employee List
• Women & Minority Organizations List This is a 'working' document. Please help us keep it up-to-date and let us know if any information included is inaccurate.

DBE Certification

• Alaska Unified Certification Program Agreement
• Appendix A and B [Required for On-site Representative(s)
• Brochure: Your Guide to DBE Certification
• DBE Application Form
• Interstate Certification Affidavit
• Personal Net Worth Form
• Personal Net Worth Affidavit
• Work Category List
• Annual No Change Declaration

DBE Compliance - Goals & Good Faith Effort (GFE)

• Specification 120
• GFE Submittal Checklist
• Contact Report (25A-321A)
• DBE Subcontractable Items (25A-324)
• DBE Utilization Report (25A-325C)
• Prime Contractor's Written DBE Commitment Form (25A-326)
• Subcontractor List (25D-5)
• Summary of DBE Participation (25A-336)
• Summary of DBE Participation (25A-336) Instructions
• Summary of GFE Documentation (25A-332A)
• CUF Monitoring Report (25A-298)

DBE Support Services

• 50% DBE Reimbursement Form FFY2024
• 50% DBE Reimbursement Instructions FFY2024
• Brochure: DBE Support Services
• Brochure: Welcome to the DBE Program - Federal Hwy Administration Programs
• Flyer: Is the DBE Program for You?

On the Job Training and Support Services

• 2023 OJT Apprentice Reimbursement Form
• 2022 OJT Support Services Reimbursement Form
• Training Program Request (25A-310)
• Brochure: OJT Support Services
• Brochure: OJT Apprentice Reimbursement Assistance
• Section 645
• Training Utilization Report (25A311)
• Apprentice Employment Report (25A312)
• Training Report (25A313)

On-Site Representative

Section 120, Part 3.04.2.e(3), which is a Special Provision of Alaska Department of Transportation and Public Facilities Construction Contracts for the Disadvantaged Business Enterprise (DBE) program, requires that DBE owners or one of their key employees be at the work site and responsible for the work performed on the contract. Key employees are individuals that have been approved as "onsite representatives" by the Civil Rights Office. To have an employee designated as an onsite representative, a completed Appendix A (Management Responsibilities form) and Appendix B (Employment History form) must be submitted to the Civil Rights Office for approval. DBE credit will not be given for work performed on departmental contracts prior to approval of the DBE firm's designated onsite representative.

• Appendix A and B

Title VI The below documents are offered in PDF format unless noted.