The Tennessee CC-3 form is a certification document required by the Tennessee Department of Transportation. It verifies that payments have been made to Disadvantaged Business Enterprises (DBEs) for work performed under a contract. Completing this form is essential for ensuring compliance with state regulations.
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The Tennessee CC-3 form plays a crucial role in the state’s efforts to support and ensure transparency in transactions involving Disadvantaged Business Enterprises (DBEs). This certification form is a requirement under the Tennessee Department of Transportation's Small Business Development Program. It serves as a formal declaration that a contractor has made full payment to a DBE for work performed under a specific contract. The form includes key details such as the names of the owner or authorized representative of both the contractor and the DBE, the contract number, and the county where the work was executed. Additionally, it outlines the amounts paid to the DBE and confirms that the contractor is authorized to make such certifications. By requiring this form, the state aims to uphold accountability and promote equitable opportunities for small businesses within public contracting. The CC-3 form is an essential document that not only protects the interests of DBEs but also ensures compliance with federal and state regulations designed to foster fair business practices.
CC-3
TENNESSEE DEPARTMENT OF TRANSPORTATION
SMALL BUSINESS DEVELOPMENT PROGRAM
PROJECT FILES SHOULD NOT BE ACCEPTED AS FINAL WITHOUT THIS FORM INCLUDED
CERTIFICATION REGARDING MONEY PAID TO DISADVANTAGED BUSINESS ENTERPRISES
I,
, certify that to the best of my knowledge,
,
Name of Owner or Authorized Representative
Name of DBE
has been paid in full, per the amount of the contract for actual work performed on:
Contract No., County, as of
I further certify that I am duly authorized to make this certification on behalf of the named contractor.
DISADVANTAGED BUSINESS ENTERPRISE
AMOUNT
Original DBE
Firm Name
Subcontract $
Subcontract
PRIME
Date
CONTRACTOR:
SIGNATURE:
Paid to date
TITLE:
Est. final pmt.
DATE:
TOTAL
Name of DBE Owner or Authorized Representative
Name of Contractor
has paid the named DBE, in full, per the amount of the contract for actual work performed on:
Rev. 1/4/10, 2/28/13
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