Civil Rights Forms
ADA
-
ADA Complaint Form
-
ADA Reasonable Accommodation Request Form
- ADA Reasonable Accommodation Employee Release
Form
- ADOT&PF ADA Work Plan
Contract Compliance
- Bidder's Registration Form (25D-6)
29K
- Required Contract Provisions for Federal-Aid Construction
Contracts (25D-55 )
317K
- Contractor's Civil Rights Representatives (25A-302)
9K
- Federal EEO Bid Conditions (25A-301)
48K
- EEO-1 Certification (25A-304)
140K
- Federal-aid Highway Construction Contractors Annual EEO Report (FHWA-1391, Rev. 06-10)
78K - Contract
Compliance Review Checklist
124K
- Monthly Employment Utilization Report (25A-303)
119K
- 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
49K
- Appendix A and B [Required for On-site Representative(s)
939K
- Brochure: Your Guide to DBE Certification
245K
- DBE Application Form
615K
- Interstate Certification Affidavit 9KB
- Personal Net Worth Form
325K
- Work Category List
316K
DBE Compliance - Goals & Good Faith Effort (GFE)
- Specification 120
163K
- Brochure: Demystifying DBE Project Goal Setting
175K
- Brochure: DBE Good Faith Efforts
146K
- GFE Submittal Checklist
26K - Contact Report (25A-321A)
183K
- DBE Subcontractable Items (25A-324)
125K
- DBE Utilization Report (25A-325C)
32K
- Prime Contractor's Written DBE Commitment Form
(25A-326)
115K
- Subcontractor List (25D-5)
159K
- Summary of DBE Participation (25A-336)
72K
- Summary of DBE Participation (25A-336) Instructions
35K
- Summary of GFE Documentation (25A-332A)
139K
- CUF Monitoring Report (25A-298)
27K
DBE Support Services
- Brochure: DBE Support Services
342K
- Brochure: Welcome to the DBE Program - Federal
Hwy Administration Programs
118K
- Flyer: Is the DBE Program for You?
8.6M
- "Map to Success" Specialized Assistance Application
- DBE Survey
72K
- 50% Reimbursement Program Application
175K
- In House Financial Assistance Application
206K
OJT Training
- Brochure: OJT Support Services
128K
- Brochure: OJT Apprentice Reimbursement Assistance
177K
- Reimbursement Assistance for Apprentices Application
204K
- Section 645
143K
- ADOT&PF Training Program Request (25A310)
197K
- Training Utilization Report (25A311)
260K
- Apprentice Trainee Employment Report (25A312)
86K
- Training Report (25A313)
118K
On-Site Representative
Section 120, Part 3.03(f)(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 939K
Title VI The below documents are offered in PDF format unless noted.
- Title VI Basic Training
3.6M - Title VI Brochure
- Title VI Work Plan
- Discrimination Complaint Questionnaire
- Title VI Complaint Process and Procedure
- Title VI Public Meeting Report
- Title VI Public Sign-In Sheet
- Civil Rights Brochures
- Title VI Documents
- ADA & Title VI policies in English & Translated
- How to file a Complaint
