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r r <br /> STATE OF CALIFORNIA Attachment 1 <br /> DISABLED VETERAN BUSINESS <br /> ENTERPRISE PARTICIPATION SUMMARY <br /> STD. 840 REVISED (3/981 <br /> FORM COMPLETION INSTRUCTIONS <br /> This form must be completed, whether your firm commits to achieving the contract goal <br /> of at least 3 percent DVBE participation under Option A of this Attachment 1, or has <br /> made a "Good Faith, Effort" under Option B of this Attachment 1. Report full or partial <br /> goal achievement. If no DVBE participation is obtained, enter "N/A" or "None." <br /> COMPANY NAME - List the name(s) of the firm(s) proposed for DVBE <br /> participation. If your firm is a DVBE and will be performing work under the <br /> contract, list your firm's name first. <br /> NATURE OF WORK - Describe the work to be performed by the proposed <br /> DVBE(s), including the work to be performed by your firm as a DVBE, if applicable. <br /> CONTRACTING WITH - List the name(s) of the department(s) or firm(s) with <br /> which the listed DVBE(s) is/are contracting. <br /> TIER - Indicate for each listed DVBE the contracting tier with the following <br /> designations: <br /> 0=Prime or Joint Contractor <br /> 1 =Primary Subcontractor/Supplier <br /> 2=Subcontractor/Supplier of Level 1 Subcontractor/Supplier <br /> 3 =Subcontractor/Supplier of Level 2 Subcontractor/Supplier, etc. <br /> CLAIMED DVBE VALUE - The total participation dollar amount claimed for the <br /> DVBE or DVBE(s) identified as participating in the contract. <br /> CERTIFICATION - To obtain DVBE participation credit, the identified DVBE firm(s) <br /> must be certified formally by the Office of Small and Minority Business. Check <br /> "Yes" if the certification verification has been included for each DVBE firm listed <br /> for participation and attach a copy of the OSMB certification letter to this Form <br /> STD 840, REVISED. <br /> 10 <br /> 102 <br />