Form SFN60638 "Monthly Record of Dbe Project Payments" - North Dakota

What Is Form SFN60638?

This is a legal form that was released by the North Dakota Department of Transportation - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2015;
  • The latest edition provided by the North Dakota Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SFN60638 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Transportation.

ADVERTISEMENT
ADVERTISEMENT

Download Form SFN60638 "Monthly Record of Dbe Project Payments" - North Dakota

Download PDF

Fill PDF online

Rate (4.8 / 5) 30 votes
MONTHLY RECORD OF DBE PROJECT PAYMENTS
For DBE Project Payment (Enter month and year)
North Dakota Department of Transportation, Civil Rights Division
SFN 60638 (Rev. 01-2015)
Prime contractors and subcontractors are required to submit a monthly record of project payments to Disadvantaged Business Enterprise (DBE) firms on highway
construction project(s). If no payments have been made, please indicate "none" on the form.
Submit by the 15th working day of every month.
Submit to: CIVIL RIGHTS DIVISION by EMAIL:
CIVILRIGHTS@ND.GOV
The payments listed should reflect those made to the listed DBE in the previous month.
or FAX: 701-328-0343
Project Number
This payment is a :
PCN
Bid Opening Date
Job Number
Partial Payment
Final Payment
Prime Contractor/Consultant
Subcontractor/Subconsultant
Payments made in the previous month are detailed below (Include additional sheets as needed.)
Dollar Amounts Paid
Intended
Remaining on Contracted
Spec &
Amount indicated on
Amount Paid
Previous
Code Items
Spec & Code Item
Original Form A and/or
on this
Amount
Total Amount
Amount
Number
Description
Request to Sublet
Payment
Paid
Paid to Date
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Subtract Amount Paid from
0.00
Total Intended Amount
0.00
0.00
0.00
0.00
0.00
Totals
The Prime Contractor is responsible for reporting all payments to all tiers of subcontracting to count toward DBE achievement.
MONTHLY RECORD OF DBE PROJECT PAYMENTS
For DBE Project Payment (Enter month and year)
North Dakota Department of Transportation, Civil Rights Division
SFN 60638 (Rev. 01-2015)
Prime contractors and subcontractors are required to submit a monthly record of project payments to Disadvantaged Business Enterprise (DBE) firms on highway
construction project(s). If no payments have been made, please indicate "none" on the form.
Submit by the 15th working day of every month.
Submit to: CIVIL RIGHTS DIVISION by EMAIL:
CIVILRIGHTS@ND.GOV
The payments listed should reflect those made to the listed DBE in the previous month.
or FAX: 701-328-0343
Project Number
This payment is a :
PCN
Bid Opening Date
Job Number
Partial Payment
Final Payment
Prime Contractor/Consultant
Subcontractor/Subconsultant
Payments made in the previous month are detailed below (Include additional sheets as needed.)
Dollar Amounts Paid
Intended
Remaining on Contracted
Spec &
Amount indicated on
Amount Paid
Previous
Code Items
Spec & Code Item
Original Form A and/or
on this
Amount
Total Amount
Amount
Number
Description
Request to Sublet
Payment
Paid
Paid to Date
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Subtract Amount Paid from
0.00
Total Intended Amount
0.00
0.00
0.00
0.00
0.00
Totals
The Prime Contractor is responsible for reporting all payments to all tiers of subcontracting to count toward DBE achievement.