1 MWBE 100 MWBE Utilization Plan.pdf

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Attached to
Standby Towing Operations & On-Call Towing Operations, Regions 2, 7, and 8
Solicitation number
2138674
Issued by
Essex County, New York

About this file

This document is a Form MWBE 100 Utilization Plan required by New York State for state and local contract opportunities. The form must be submitted with any bid or proposed negotiated contract prior to contract award, as specified in the Invitation for Bid (IFB) or Request for Quote (RFQ). The utilization plan requires contractors to provide detailed descriptions of supplies and services to be provided by each certified Minority and Women-owned Business Enterprise (MWBE) under the contract, including the names, addresses, telephone numbers, email addresses, and Federal ID numbers of certified M/WBE subcontractors and suppliers. Contractors must also specify the dollar value of subcontracts and supplies/services and the intended performance dates for each component.

The form establishes minimum participation goals for both Minority Business Enterprises (MBE) and Women-owned Business Enterprises (WBE) as percentages outlined in the specific contract requirements. If a contractor is unable to fully meet the established MBE and WBE goals, the contractor must submit Good Faith Efforts (GFE) documentation and request a waiver upon completion of the contract. Submission of the completed form constitutes the contractor's acknowledgement and agreement to comply with M/WBE requirements under NYS Executive Law, Article 15-A and 5 NYCRR Part 142. Failure to submit complete and accurate information may result in noncompliance findings, bid rejection, or contract suspension or termination. The form includes sections for agency use only, documenting review dates, approval status, contract award dates, estimated completion dates, contract amounts, and issuance of deficiency notices and notices of acceptance.

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Text version

Form MWBE 100

MWBE Utilization Plan (6/15)

MWBE UTILIZATION PLAN

INSTRUCTIONS: This form must be submitted with any bid or proposed negotiated contract or within a reasonable time thereafter, but prior to contract award as required in the IFB or RFQ. This Utilization Plan must contain a detailed description of the supplies and/or services to be provided by each certified Minority and Women-owned Business Enterprise (MWBE) under the contract. Attach additional sheets if necessary.

Contractor’s Name, Address and Telephone No.

Federal Identification No.

Contract No.:

Contract Description & Location (Region)

MWBE Goals In Contract

MBE %

WBE %

Certified M/WBE Subcontractors/Suppliers Name, Address, Telephone No, E-mail Address Federal ID. No.

NYS ESD CERTIFIED Detailed description of Work (Attach additional sheets if necessary)

Dollar Value of Subcontracts/ supplies/ services and intended performance dates of each component of the contractMBE WBE

IF UNABLE TO FULLY MEET THE MBE AND WBE GOALS SET FORTH IN THE CONTRACT, CONTRACTOR MUST SUBMIT GOOD FAITH EFFORTS (GFE) DOCUMENTATION and A REQUEST FOR

WAIVER UPON COMPLETION OF CONTRACT

Submission of this form constitutes the contractor’s acknowledgement and agreement to comply with the M/WBE requirements set forth under NYS Executive Law, Article 15-A and 5 NYCRR Part 142. Failure to submit complete and accurate information may result in a finding of noncompliance or rejection of the bid/proposal and/or suspension or termination of the contract.

Prepared By (Signature) Email Address

Name and Title of Preparer (Print or Type) Telephone No. Date

Form MWBE 100

MWBE Utilization Plan (6/15)

FOR AGENCY USE ONLY

Reviewed By Date

Utilization Plan Approved Yes No Date

Contract No. Project No. (If applicable) Contract Award Date Estimated Completion Date Contract Amount Obligated

Notice of Deficiency Issued Yes No Date

Description of Work

Notice of Acceptance Issued Yes No Date

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