17._Prime-DVBE-Sub-Report.pdf
PDF 119 KB Posted
- Attached to
- International Hall Exterior Stair Replacement
- Solicitation number
- 0000039088
- Issued by
- Sonoma County, Sonoma City, Sonoma State University CDP, California
About this file
This is a Prime Contractor's Disabled Veteran Business Enterprise (DVBE) Subcontracting Report form issued by The Trustees of The California State University and the State of California Department of General Services. The form is designed to track and report on subcontracting activities with DVBE firms for state contracts managed through California State University.
The report requires prime contractors to disclose all Disabled Veteran Business Enterprise firms involved with their contracts, including the subcontractor names, addresses, contracted amounts, and payment amounts received. Contractors must report the total number of DVBE subcontractors, the total contracted amount to DVBE firms, and the total payment amount distributed to those firms. The form must be completed and returned within 60 days from receipt of final payment on the contract. The document includes fields for contract numbers, award amounts, received amounts, variance amounts, contract completion dates, and campus-specific contact information. Contractors are required to sign the form under penalty of perjury, certifying that all submitted information is true and accurate. Persons with disabilities requiring reasonable modifications should contact the OSDS Report Coordinator at (916) 375-4937 or OSDSReports@dgs.ca.gov.
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Text version
The Trustees of The California State University
Prime Contractor's DVBE Subcontracting Report STATE OF CALIFORNIA
(Rev. April 2014)
Contract Number: Department:
Prime Contractor:
FEIN Number:
Phone Number:
Address:
Email Address:
DVBE Number Total Contracted Amount to DVBE
Total Payment Amount to
DVBE
0 -$ -$
Use next tab for additional lines
DVBE Subcontractor(s) Name DVBE Subcontractor(s) Address
Grand TotalNumber of DVBE Subcontractors
I declare under penalty of perjury under the laws of the State of California that all information submitted is true and correct.
Date:
Signature:
Prime Contractor Print Name:
Date Final Payment Received:
Return within 60 days from receipt of final payment.
List all Disabled Veteran Business Enterprise firms involved with this contract.
Contract Received Amount:
Variance
{Campus: enter campus name and name of person(s) who should receive this report}
Date Contract Completed: Contract Award Amount:
Americans with Disabilities (ADA) Notice: Persons with disabilities requiring reasonable modifications should contact the OSDS Report Coordinator at (916) 375-4937 or OSDSReports@dgs.ca.gov
File details come from the government source that posted it. Updated .