1-MBE-WBE Documents Package.pdf

PDF 351 KB Posted

Attached to
Nitric Oxide Therapy Devices and Supply
Solicitation number
H25-25-140
Issued by
Cook County, Illinois

About this file

These documents are Minority/Women Business Enterprise (M/WBE) Utilization Plan forms from Cook County, Illinois, specifically Form 1 (Utilization Plan), Form 2 (Letter of Intent), and Form 3 (Petition for Waiver of Participation). The forms are designed to promote diversity and inclusion in county contracting by documenting and encouraging participation of minority and women-owned businesses in county contracts.

The forms provide a structured process for bidders/proposers to demonstrate their commitment to M/WBE participation. Form 1 allows businesses to indicate their M/WBE status, whether they are a certified M/WBE firm, a joint venture with M/WBE partners, or planning to utilize M/WBE firms as subcontractors. Form 2 serves as a Letter of Intent where potential M/WBE subcontractors can detail their proposed participation, including scope of work and payment terms. Form 3 provides a mechanism for bidders to request a waiver of M/WBE participation requirements, which requires documentation of good faith efforts to engage M/WBE firms. These forms were revised on 01/29/2014 and are part of Cook County's efforts to ensure fair and inclusive contracting practices.

View the file

Other files

File Type Posted
4-RFP H25-25-140 Nitric Oxide.pdf PDF
5-Price Proposal H25-25-140 Nitric Oxide RFP.xlsx XLSX spreadsheet
6-New Supply Template - 041320.docx DOCX document
2-CCH Addendum Acknowledgement.pdf PDF
3-CCH EDS Form.pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

M/WBE Utilization Plan - Form 1 Revised: 01/29/2014

CONTRACT NO.

MBE/WBE UTILIZATION PLAN - FORM 1

BIDDER/PROPOSER HEREBY STATES that all MBE/WBE firms included in this Plan are certified MBEs/WBEs by at least one of the entities listed in the General Conditions – Section 19.

I. BIDDER/PROPOSER MBE/WBE STATUS: (check the appropriate line)

____ Bidder/Proposer is a certified MBE or WBE firm. (If so, attach copy of current Letter of Certification)

____ Bidder/Proposer is a Joint Venture and one or more Joint Venture partners are certified MBEs or WBEs. (If so, attach copies of Letter(s) of Certification, a copy of Joint Venture Agreement clearly describing the role of the MBE/WBE firm(s) and its ownership interest in the Joint Venture and a completed Joint Venture Affidavit – available online at www.cookcountyil.gov/contractcompliance)

____ Bidder/Proposer is not a certified MBE or WBE firm, nor a Joint Venture with MBE/WBE partners, but will utilize MBE and WBE firms either directly or indirectly in the performance of the Contract. (If so, complete Sections II below and the Letter(s) of Intent – Form 2).

II. Direct Participation of MBE/WBE Firms Indirect Participation of MBE/WBE Firms

NOTE: Where goals have not been achieved through direct participation, Bidder/Proposer shall include documentation outlining efforts to achieve Direct Participation at the time of Bid/Proposal submission. Indirect Participation will only be considered after all efforts to achieve Direct Participation have been exhausted. Only after written documentation of Good Faith Efforts is received will Indirect Participation be considered.

MBEs/WBEs that will perform as subcontractors/suppliers/consultants include the following:

MBE/WBE Firm: ____________________________________________________________________________

Address: __________________________________________________________________________________

E-mail: ___________________________________________________________________________________

Contact Person: ___________________________________ Phone: __________________________________

Dollar Amount Participation: $__________________________________________________________________

Percent Amount of Participation: _____________________________________________________________%

*Letter of Intent attached? Yes _______ No _______ *Current Letter of Certification attached? Yes _______ No _______

MBE/WBE Firm: ___________________________________________________________________________

Address: __________________________________________________________________________________

E-mail:____________________________________________________________________________________

Contact Person: ___________________________________ Phone: __________________________________

Dollar Amount Participation: $__________________________________________________________________

Percent Amount of Participation: _____________________________________________________________%

*Letter of Intent attached? Yes _______ No _______ *Current Letter of Certification attached? Yes _______ No _______

Attach additional sheets as needed.

* Letter(s) of Intent and current Letters of Certification must be submitted at the time of bid.

http://www.cookcountyil.gov/contractcompliance

M/WBE Utilization Plan - Form 2 Revised: 1/29/14

MBE/WBE LETTER OF INTENT - FORM 2

M/WBE Firm: Certifying Agency:

Contact Person:

Address:

Certification Expiration Date:

Ethnicity: ________________________________________

City/State: Zip: _____________ Bid/Proposal/Contract #:

Phone: __________________ Fax: FEIN #: _________________________________________

Email:

Participation: [ ] Direct [ ] Indirect

Will the M/WBE firm be subcontracting any of the goods or services of this contract to another firm?

[ ] No [ ] Yes – Please attach explanation. Proposed Subcontractor(s):

The undersigned M/WBE is prepared to provide the following Commodities/Services for the above named Project/ Contract: (If more space is needed to fully describe M/WBE Firm’s proposed scope of work and/or payment schedule, attach additional sheets)

Indicate the Dollar Amount, Percentage, and the Terms of Payment for the above-described Commodities/ Services:

THE UNDERSIGNED PARTIES AGREE that this Letter of Intent will become a binding Subcontract Agreement for the above work, conditioned upon (1) the Bidder/Proposer’s receipt of a signed contract from the County of Cook; (2) Undersigned Subcontractor remaining compliant with all relevant credentials, codes, ordinances and statutes required by Contractor, Cook County, and the State to participate as a MBE/WBE firm for the above work. The Undersigned Parties do also certify that they did not affix their signatures to this document until all areas under Description of Service/ Supply and Fee/Cost were completed.

Signature (M/WBE) Signature (Prime Bidder/Proposer)

Print Name Print Name

Firm Name Firm Name

Date Date

Subscribed and sworn before me Subscribed and sworn before me this ____ day of , 20____. this ____ day of , 20____.

Notary Public Notary Public _______________________________

SEAL SEAL

M/WBE Utilization Plan - Form 3 Revised: 01/29/14

PETITION FOR WAIVER OF MBE/WBE PARTICIPATION – FORM 3

A. BIDDER/PROPOSER HEREBY REQUESTS:

FULL MBE WAIVER FULL WBE WAIVER

REDUCTION (PARTIAL MBE and/or WBE PARTICIPATION)

_____% of Reduction for MBE Participation _____% of Reduction for WBE Participation

B. REASON FOR FULL/REDUCTION WAIVER REQUEST

Bidder/Proposer shall check each item applicable to its reason for a waiver request. Additionally, supporting documentation shall be submitted with this request.

(1) Lack of sufficient qualified MBEs and/or WBEs capable of providing the goods or services required by the contract. (Please explain)

(2) The specifications and necessary requirements for performing the contract make it impossible or economically infeasible to divide the contract to enable the contractor to utilize MBEs and/or WBEs in accordance with the applicable participation. (Please explain)

(3) Price(s) quoted by potential MBEs and/or WBEs are above competitive levels and increase cost of doing business and would make acceptance of such MBE and/or WBE bid economically impracticable, taking into consideration the percentage of total contract price represented by such MBE and/or WBE bid. (Please explain)

(4) There are other relevant factors making it impossible or economically infeasible to utilize MBE and/or WBE firms. (Please explain)

C. GOOD FAITH EFFORTS TO OBTAIN MBE/WBE PARTICIPATION

(1) Made timely written solicitation to identified MBEs and WBEs for utilization of goods and/or services;

and provided MBEs and WBEs with a timely opportunity to review and obtain relevant specifications, terms and conditions of the proposal to enable MBEs and WBEs to prepare an informed response to solicitation. (Attach of copy written solicitations made)

(2) Used the services and assistance of the Office of Contract Compliance staff. (Please explain)

(3) Timely notified and used the services and assistance of community, minority and women business organizations. (Attach of copy written solicitations made)

(4) Followed up on initial solicitation of MBEs and WBEs to determine if firms are interested in doing business. (Attach supporting documentation)

(5) Engaged MBEs & WBEs for direct/indirect participation. (Please explain)

D. OTHER RELEVANT INFORMATION

Attach any other documentation relative to Good Faith Efforts in complying with MBE/WBE participation.

File details come from the government source that posted it. Updated .