2-Form 3 - MWSBE Utilization Form.docx

CBI FORM 3: Subcontractor / Supplier Utilization Commitment This form MUST be submitted at the time of Proposal Opening. Copy this CBI Form 3 as needed.

Failure to properly complete and submit Form 3 with the Proposal constitutes grounds for rejection of the Proposal.

Per Section 3.5 of the CBI Administrative Procedures Manual, the Subcontractor/Supplier Utilization Commitment (CBI Form 3), captures information regarding the MWSBEs and other subcontractors and suppliers that the Proposer intends to use on the Contract FOR ALL TIERS.

M/W/SBEs must satisfy the requirements of Section 2 of the CBI Administrative Procedures Manual in order to count the work they intend to perform on the contract with its own current workforces towards the Contract Goal and must list themselves below.

Proposer Name:

Project Name:

MWBE Goal:

MBE Goal:

MSBE Goal:

WBE Goal:

MWSBE Goal:

SBE Goal:

List below all M/W/SBEs that you intend to use on this Contract. NOTE: You will only receive credit for M/W/SBEs that are currently certified with the City as of the Proposal Opening Date.

M/W/SBE Vendor Name (Non-Hauling Services)

CBI FORM 3: Subcontractor / Supplier Utilization Commitment

List below all non-M/W/SBEs (subcontractors and suppliers) that you intend to use on this Contract

Letters of Intent submitted upon notice from the City Per Section 3.5 of the CBI Administrative Procedures Manual, within three (3) Business Days after receiving a request from the City (or within such longer time as may be communicated by the City in writing), Proposers must submit a separate Letter of Intent (CBI Form 4) for each M/W/SBE listed on CBI Form 3. Each Letter of Intent must be executed by both the M/W/SBE and the Proposer. The City shall not count proposed M/W/SBE utilization for which it has not received a Letter of Intent by this deadline. The Proposer is still obligated to pay the M/W/SBE the full amount listed on the Contract with the M/W/SBE regardless of what percentage is actually counted towards the M/W/SBE Goal.

Adding subcontractors or suppliers after submitting this form Nothing in this certification shall be deemed to preclude you from entering into subcontracting arrangements after submission of this form. However, per the CBI Administrative Procedures Manual, you must comply with the following:

· You must maintain the level of M/W/SBE participation stated in the Contract throughout the duration of the Contract, except as specifically allowed in Section 5

· If you need to terminate or replace a M/W/SBE, you must comply with Section 5.3

· If the scope of work on the Contract increases, or if you elect to subcontract any portion of work not identified on this form as being subcontracted, then you must comply with Section 5.4

· A Letter of Intent (CBI Form 4) must also be submitted for each M/W/SBE you add subsequent to contract award.

All Subcontractors and Suppliers must be registered with the City of Charlotte.

Pursuant to the City’s Vendor Registration Policy, each subcontractor or supplier (non-MBE/SBE, WBEs, SBEs and MBEs) that you use on this contract must be registered in the City’s vendor database.

Signature Your signature below indicates that the undersigned firm certifies and agrees that:

Signature of Authorized Official

Printed Name

Title

Submittal Date

Version 06-2023 image1.png