23-003 AMENDMENT #1.pdf
PDF 874 KB Posted
- Attached to
- PRE-QUAL FOR CHEMICALS, PURCHASE & DELIVERY
- Solicitation number
- RPQ 680 23-003/CR-1 3
- Issued by
- Palm Beach County, Florida
About this file
This is an Amendment #1 form (OEBO Schedule 1, revised 09/22/2022) for a Palm Beach County, Florida solicitation related to pre-qualification for chemicals purchase and delivery services. The document serves as a template for bidders to report their participation structure, including the dollar amount or percentage of work to be completed by the prime contractor and all subcontractors or subconsultants on the project. The form requires identification of the solicitation number, opening/submittal date, and county department involved, along with complete contact information for the prime respondent/bidder.
The form is designed to track certified Small, Minority, and Women Business Enterprise (S/M/WBE) participation as part of Palm Beach County's Affirmative Procurement Initiative (API). Bidders must indicate the dollar amount or percentage of work for each subcontractor or subconsultant and categorize them by certification status (MBE, WBE, SBE, or Non-SBE) and demographic category (Black, Hispanic, Women, Caucasian, Asian, or Other). Only firms certified by Palm Beach County at the time of the solicitation due date are eligible to meet the established API requirements. The form requires an authorized signature certifying the accuracy of the information provided and notes that any modification of the form will result in rejection upon submittal. All amounts listed for subcontractors must be supported by properly executed Schedule 2 or attached signed proposals.
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Other files
| File | Type | Posted |
|---|---|---|
| 23-003-CR-CHEMICALS.pdf | ||
| 23-003-CR_2_052223.pdf |
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Text version
OEBO SCHEDULE 1
REVISED 09/22/2022
SOLICITATION/PROJECT/BID NAME: _________________________________________ SOLICITATION/PROJECT/BID NO.: ______________________________________
SOLICITATION OPENING/SUBMITTAL DATE: ___________________________________ COUNTY DEPARTMENT: ______________________________________________
Section A PLEASE LIST THE DOLLAR AMOUNT OR PERCENTAGE OF WORK TO BE COMPLETED BY THE PRIME CONTRACTOR/CONSULTANT* ON THE PROJECT:
NAME OF PRIME RESPONDENT/BIDDER: _______________________________________________ ADDRESS: ___________________________________________________
CONTACT PERSON: _______________________________________________________ PHONE NO.: ________________________ E-MAIL:_________________________________
PRIME’S DOLLAR AMOUNT OR PERCENTAGE OF WORK: __________________________________ Non-SBE MBE WBE SBE *SMWBE Prime’s must include their percentage or dollar amount in the Total Participation line under section B.
Section B PLEASE LIST THE DOLLAR AMOUNT OR PERCENTAGE OF WORK TO BE COMPLETED BY ALL SUBCONTRACTORS/SUBCONSULTANTS ON THE PROJECT BELOW:
(Check all Applicable Categories)
Subcontractor/Sub consultant Name MBE WBE SBE
Non-SBE Minority Women Small
Business Business Business
DOLLAR AMOUNT OR PERCENTAGE OF WORK
Black Hispanic Women Caucasian Asian Other
1.
2.
3.
4.
5.
(Please use additional sheets if necessary)
Total ___________ ___________ ____________ ___________ __________ ___________
Total Bid/Offer Price $______________________________________ Total Certified S/M/WBE Participation $ _____________
I hereby certify that the above information is accurate to the best of my knowledge: ______________________________
Name & Authorized Signature Title
Note: 1. The amount listed on this form for a Subcontractor/sub consultant must be supported by price or percentage listed on the properly executed Schedule 2 or attached signed proposal.
2. Only those firms certified by Palm Beach County at the time of solicitation due date are eligible to meet the established OEBO Affirmative Procurement Initiative (API). Please check the applicable box and list the dollar amount or percentage under the appropriate demographic category.
3. Modification of this form is not permitted and will be rejected upon submittal.
File details come from the government source that posted it. Updated .