10-4. ECMCC-Exhibit A-3-SDVOB 0% (2024).pdf
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- Attached to
- GIFT CARD PROGRAM FOR GRANT PURPOSES
- Solicitation number
- 202521
- Issued by
- Erie County, New York
About this file
This is a Service-Disabled Veteran-Owned Business (SDVOB) Utilization Plan form submitted to Erie County Medical Center Corporation (ECMCC) for a gift card program procurement supporting grant-funded programs in New York. The form requires respondents to detail their use of certified SDVOB subcontractors and suppliers, including the names, addresses, contact information, federal identification numbers, and specific descriptions of work or supplies to be provided by each SDVOB participant. Respondents must submit the completed utilization plan with their proposal, as a negotiated contract proposal, or within 48 hours of receiving notice from ECMCC that they are the apparent lowest responsible bidder. The form includes fields for contract identification, RFP or bid number, federal identification number, and contract value documentation.
The SDVOB goal for this particular contract is set at 0%, meaning no SDVOB participation requirement is mandated for this solicitation. Respondents must acknowledge their understanding of and agreement to comply with New York State Executive Law, Veteran's Service Law Article 3, and 9 NYCRR Part 252 regarding SDVOB requirements. Failure to submit complete and accurate information on the utilization plan may result in findings of noncompliance, bid rejection, or contract termination. The form includes a section for ECMCC review and approval, with provisions for issuing notices of deficiency or acceptance based on the completeness and compliance of the submitted utilization plan.
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Text version
SDVOB Utilization Plan rev 1/24
EXHIBIT A-3
SDVOB UTILIZATION PLAN
INSTRUCTIONS: This form must be submitted with any proposal or proposed negotiated contract or within 48 hours of notice from ECMCC that the respondent is the apparent lowest responsible bidder to an IFB. This Utilization Plan must contain a detailed description of the supplies and/or services to be provided by each certified Service-Disabled
Veteran-Owned Business (SDVOB) under the contract. Attach additional sheets if necessary.
Respondent’s Name: _____________________________________________________ RFP or Bid No.: __________________________________________________
Federal Identification No.: ___________________________________________ SDVOB Goals in the Contract: 0%
Contract Value: ____________________________________________________
1. Certified SDVOB Subcontractors/Suppliers
Name, Address, Email Address, Telephone No.
2. Federal ID
No.
3. Detailed Description of Work
(Attach additional sheets, if necessary)
4. Dollar Value or percentage of
Subcontracts/
Supplies/Services
1.
2.
3.
4.
5.
6.
SDVOB Utilization Plan rev 1/24
7.
8.
PREPARED BY (Signature):
DATE:
NAME AND TITLE OF PREPARER (Print or Type):
SUBMISSION OF THIS FORM CONSTITUTES THE OFFEROR’S ACKNOWLEDGEMENT AND AGREEMENT TO COMPLY WITH THE SDVOB REQUIREMENTS SET FORTH UNDER NYS EXECUTIVE LAW, VETERAN’S SERVICE
LAW ARTICLE 3, 9 NYCRR PART 252, AND THE ABOVE-REFERENCED SOLICITATION. FAILURE TO SUBMIT
COMPLETE AND ACCURATE INFORMATION MAY RESULT IN A FINDING OF NONCOMPLIANCE AND/OR REJECTION OF YOUR BID/PROPOSAL AND/OR POSSIBLE TERMINATION OF YOUR CONTRACT. UTILIZATION OF
CERTIFIED SDVOB’s FOR NON-COMMERCIALLY USEFUL FUNCTIONS MAY NOT BE COUNTED TOWARD SDVOB
REQUIREMENTS.
TELEPHONE NO.:
EMAIL ADDRESS:
FOR ECMCC SDVOB USE ONLY
REVIEWED BY:
DATE:
UTILIZATION PLAN APPROVED: YES NO Date:
Contract No.: Project No. (if applicable):
Contract Award Date:
Estimated Date of Completion:
Amount Obligated Under the Contract:
Description of Work:
NOTICE OF DEFICIENCY ISSUED: YES NO Date:______________
NOTICE OF ACCEPTANCE ISSUED: YES NO Date:_____________
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