Date

Name of Prime Contractor Firm Prime Contractor Business Name DBE Address City, State Zip Code

Subject: District Response - Request for Joint Check Use

Project/CSJ/County: <Project/CSJ/County>

Dear Mr./Ms. Last Name:

The <District Name> district has reviewed the Joint Check Approval request submitted <Date>. Upon review of this request and supporting documentation, it has been determined that the request for use of joint check is denied for the following reasons:

List Reason(s) for denial.

Should you have any questions or require further information concerning this matter, please contact <Contact Name> at <(XXX) Number>.

Sincerely,

District Representative Name

District, Title

CC: