100_BOR_EO_Outreach_Forms_1-2-3_CMAR.pdf

Small Business (SB) Program – Bureau of Reclamation

08_26-IFR BOR CMAR FORM EO1 - 100

FORM EO1 - 100 - STATEMENT OF OUTREACH COMMITMENT

(Due with submittal)

Project Number:

Project Title:

By submitting a response to this solicitation, the Submitter affirms its commitment to support the City’s small business program participation through the outreach process described herein.

Section A: Submitter Information On behalf of the Submitter, I certify that the following information is true and correct:

Company Name:

Company Mailing Address:

Representative Name:

Title:

Email Address:

Phone Number:

Section B: Outreach Commitment As a Submitter to this solicitation, we agree to:

1. Actively support small business participation by completing all required outreach activities as outlined in the solicitation.

2. Submit documentation of outreach efforts and commitment to small business utilization (FORM EO1-100 due at the time of submittal. Forms EO2-100 and EO3-100 by a date determined by the City)

Signature: __________________________________ Date: _____________________

FORM EO2 - 100 - BIDDERS LIST AND SMALL BUSINESS OUTREACH

Name of Company (Submitter):

Contract #/Project #:

Contract Name:

Contact Person:

Phone #:

Email:

Submitters must conduct outreach efforts and submit supporting documentation of those efforts, as described in the 2 CFR 200, in accordance with the detailed instructions in the Contract Clauses. Submitters should make copies of this form as needed. Sections A and B must be completed for all businesses that provide a proposal to the Submitter.

Sections C, D, and E are required to be completed for all small businesses.

proposed by the Submitter. Supporting documentation is required for columns C and E.

(A)

Business Name and Contact Information

(B)

Scope(s) of Work Solicited

(C)

Solicitation Method

*(D)

Selection Decision

(E)

Communication Final Selection Outcome

Name: NAICS Codes and Scope(s) of Work:

E-mail Blast

Phone Call

Firm was selected

Firm was not selected

Provide explanation of why firm NOT selected

Date Firm was Notified:

Method used to Communicate Selection:

Email

Phone

Fax

Letter

In Person

Address:

City, State, Zip: # of Employees

Newspaper

Website Phone Number: Email or Fax:

Trade Listing

Age of Business:

Range of Annual Gross

Receipts:

Outreach Event

Is firm a small business?

(Check box if yes)

Other:

Name:

NAICS Codes and Scope(s) of Work:

E-mail Blast

Phone Call

Firm was selected

Firm was not selected

Provide explanation of why firm

NOT selected

Date Firm was Notified:

Method used to Communicate Selection:

Email

Phone

Fax

Letter

Address:

City, State, Zip: # of Employees In Person

Newspaper

Email or Fax:

Website

Age of Business: Range of Annual Gross Receipts:

Trade Listing

Outreach Event

Is firm a small business?

(Check box if yes) Other:

*Firms must be notified of final selection outcome prior to submittal of this form.

Form and supporting documentation are due by a date determined by the City.

08_26-IFR BOR CMAR FORM EO2 - 100

08_26 – IFR BOR CMAR FORM EO3 - 100

FORM EO3 - 100 – SMALL BUSINESS UTILIZATION COMMITMENT

(Due by a date determined by the City)

Contract #/Project #:

Contract Name:

On behalf of the Submitter, I certify that the following information is true and correct:

1. The firms indicated as “Selected” in Form EO2 - 100 - Small Business Outreach Efforts will participate in this contract.

2. The Successful Submitter will comply with the Post-Award compliance requirements as stated in the DBE- Neutral contract clause.

3. Successful Submitter understands and agrees that any and all changes or substitutions to subcontracts with Small Businesses must be authorized by the City, prior to implementation; and

4. The following statement is true and correct:

The proposed total participation ($) on this contract will be:

Name of Selected Small Business as identified on FORM EO2

Small Business Utilization Commitment ($ Amount)

Small Business Verification

THIS SECTION TO BE COMPLETED BY

CITY OF PHOENIX ONLY

Is the business a verified small business

YES NO

Submitters should attach an additional page if more “Selected” firms are identified.

Company Name:

Company Mailing Address:

Representative Name:

Title:

Email Address:

Signature: Date: