15-BEH-FRM - 609 -Prime Self Performance Declaration.docx
DOCX document 117 KB Posted
- Attached to
- HIPP NonFederal Home Repair Services
- Solicitation number
- BCZ26 - 00029595
- Issued by
- Dallas County, Texas
About this file
This is a Prime Self-Performance Declaration form (BEH-FRM-609) issued by the City of Dallas under the Dallas Regional Inclusive Vendor Enterprise (DRIVE) program, applicable to the Home Improvement and Preservation Program (HIPP) NonFederal Home Repair Services contract opportunity. The form serves as a certification mechanism requiring Small Business Enterprise (SBE) prime contractors to declare and document the specific portions of work they will self-perform on the contract. The declaration requires primes to identify discrete work elements, associated NAICS codes, detailed descriptions of self-performed work, and the estimated contract value and percentage of total contract value attributed to such work. The form establishes a baseline for compliance verification prior to contract execution.
The declaration mandates that all self-performed work must satisfy Commercially Useful Function (CUF) requirements, meaning the SBE prime must utilize its own workforce, manage and supervise work, use its own equipment or standard commercial lease arrangements, and maintain responsibility for work execution. The form requires certification that the prime has not artificially consolidated scopes of work or restricted subcontracting opportunities to inflate self-performance percentages, and that all identified SBE subcontractors are properly certified in their respective NAICS codes. Any changes to approved subcontractor participation or work reallocation require prior written approval from the Business Enterprise HUB (BEH) staff. Self-performed work will be subject to ongoing monitoring and compliance review throughout the contract term in accordance with DRIVE Monitoring and Compliance procedures.
View the file
Other files
Show all 17
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
Dallas Regional Inclusive Vendor Enterprise Prime Self-Performance Declaration
BEH-FRM-609.SAW
Prime Vendor Information
| Prime Vendor Name |
| Solicitation Number |
| Solicitation Title |
Under the DRIVE Policy, Small Business Enterprise (SBE) primes may count self-performed work toward the contract-specific SBE goal only when that work meets Commercially Useful Function (CUF) requirements and when the SBE firm is properly certified in the NAICS code(s) associated with the work it will perform.
This declaration confirms the SBE prime’s self-performance scope and enables the Business Enterprise HUB (BEH) staff to verify CUF compliance and appropriate NAICS certification before contract execution.
Description of Self – Performed Work Identify the specific portion(s) of work your firm will self-perform as the SBE prime. Include NAICS code(s), work element/packages(s), and a brief description of work.
| NAICS Code(s): |
| Work Element/Package Identify the discrete subcontracting opportunity or supplier package (e.g., trade discipline or bid package): |
| Description of Work |
Briefly describe portion of work included in this package for this contract. Focus on what is include or excluded, not the full contract scope.)
EXAMPLE
238220 – Plumbing, Heating, and Air-Conditioning Contractors
| Mechanical Equipment Installation – Building A HVAC Package |
| Self-perform installation of five (5) owner-furnished rooftop HVAC units and associated ductwork for Building A only. Includes labor, supervision, duct fabrication, and installation. Excludes purchase of HVAC units, electrical connections, BAS programming, and work in other buildings. |
(Add additional pages as needed)
| Prime’s Estimated Contract Value ($): |
| Percentage (%) of Total Contract: |
CUF & NAICS Certification Attestation To count toward the SBE goal, self-performed work must be performed under a Commercially Useful Function (CUF), meaning the Prime:
• Uses its own workforce
• Manages and supervises the work
• Uses its own equipment (or standard commercial lease)
• Is responsible for execution of the work ☐ We certify that all self-performed work listed above will be performed under a CUF and within the Prime’s certified NAICS code(s).
☐ We further certify that all SBE subcontractors identified in the approved SBE Utilization Plan are certified in the NAICS code(s) associated with their scopes of work.
Subcontracting Opportunity Attestation ☐ We certify that commercially reasonable subcontracting opportunities were evaluated consistent with DRIVE policy, and that our firm has not restricted, reduced, or artificially consolidated scopes of work in order to increase SBE prime self-performance.
Subcontracting & No Substitution Statement ☐ We understand that any change to approved subcontractor participation or reallocation of work requires prior BEH approval through submission of the applicable revision and change request forms.
Certification I certify that the information provided in this Self-Performance Declaration is accurate and that all self-performed SBE work will comply with DRIVE Policy requirements, CUF requirements, and NAICS certification requirements.
☐ We understand that self-performed work will be subject to monitoring and compliance review throughout the life of the contract in accordance with DRIVE Monitoring & Compliance procedures.
Officer Signature:
| Printed Name: |
| Title: |
| Date: |
BEH-FRM-609.SAW Revision Date: 2026.03.01 Page 1 of 1 image1.png
File details come from the government source that posted it. Updated .