2-Attachment 3 Small Business Unavailability Certificate.pdf
PDF 117 KB Posted
- Solicitation number
- IFB 26-04
- Issued by
- Harris County, Texas
About this file
This document is a Small Business Unavailability Certificate (Attachment No. 3), which is a form designed to document a bidder's attempts to engage small businesses for a specific project. The form provides a structured template for recording details of outreach efforts to small businesses, including the date contacted, business name, telephone number, contact person, materials or services sought, and the results of those contact attempts. The form requires the bidder to certify that they made a good faith effort to involve small businesses but were unable to secure their participation.
The certificate serves as a formal documentation mechanism for proposers to demonstrate compliance with small business participation requirements. By completing this form, the bidder attests that the listed small businesses were either unavailable, unable to prepare a proposal, or had their proposal rejected. The form is intended to be submitted with proposal documents as part of a waiver process for small business participation, indicating that the proposer made reasonable efforts to include small businesses in the project but could not successfully do so. The document includes space for six potential small business contacts and requires a signature to validate the information provided.
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Text version
ATTACHMENT NO. 3
SMALL BUSINESS UNAVAILABILITY CERTIFICATE
I, ________________________________________, ________________________________________, of _______________________________________ (Name) (Title) (Name of Bidder’s Company)
Certify that on the date(s) shown, the small businesses listed herein were contacted to solicit Proposals for Materials or Services to be used on this project.
DATE CONTACTED SMALL BUSINESS NAME TELEPHONE NO. CONTACT PERSON MATERIALS OR SERVICES RESULTS
1.
2.
3.
4.
5.
6.
To the best of my knowledge and belief, said small business was unavailable for this solicitation, unable to prepare a proposal or prepared a proposal that was rejected for the reason(s) stated in the RESULTS column above.
The above statement is a true and accurate account of why I am unable to commit to awarding subcontract(s) or supply order(s) to the small business listed above.
NOTE: This form to be submitted with all Proposal documents for waiver of small business participation. (See Instructions to Proposers)
Signature:
| I: |
| undefined: |
| of: |
| SMALL BUSINESS NAME1: |
| TELEPHONE NO1: |
| CONTACT PERSON1: |
| MATERIALS OR SERVICES1: |
| RESULTS1: |
| SMALL BUSINESS NAME2: |
| TELEPHONE NO2: |
| CONTACT PERSON2: |
| MATERIALS OR SERVICES2: |
| RESULTS2: |
| SMALL BUSINESS NAME3: |
| TELEPHONE NO3: |
| CONTACT PERSON3: |
| MATERIALS OR SERVICES3: |
| RESULTS3: |
| SMALL BUSINESS NAME4: |
| TELEPHONE NO4: |
| CONTACT PERSON4: |
| MATERIALS OR SERVICES4: |
| RESULTS4: |
| SMALL BUSINESS NAME5: |
| TELEPHONE NO5: |
| CONTACT PERSON5: |
| MATERIALS OR SERVICES5: |
| RESULTS5: |
| SMALL BUSINESS NAME6: |
| TELEPHONE NO6: |
| CONTACT PERSON6: |
| MATERIALS OR SERVICES6: |
| RESULTS6: |
| Text1: |
| Text2: |
| Text3: |
| Text4: |
| Text5: |
| Text6: |
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