27-14 MINORITY BUSINESS ENTERPRISE (MBE) FORM.docx
DOCX document 17 KB Posted
- Solicitation number
- 146019
- Issued by
- Howard County, Maryland
About this file
This is a Minority Business Enterprise (MBE) Form submitted by the Columbia Association for Solicitation Number 27-13, which concerns the supply of towels for members of CA Sport and Fitness Facilities in Maryland. The form must be submitted with all bids and proposals; failure to complete and submit it accurately may result in the bid being deemed unresponsive or ineligible for contract award. Bidders are required to achieve a minimum of twenty-three percent (23%) MBE participation, which may be fulfilled through either prime or subprime participation arrangements. Vendors are encouraged to utilize a diverse group of subcontractors and suppliers across various MBE classifications, with all participating firms required to hold current certification status.
All certified MBE firms must be verified through the Maryland Department of Transportation (MDOT) directory. The form requires vendors to document total MBE participation by category—African American, Asian American, Hispanic American, Women-Owned, and Disabled—along with corresponding dollar amounts and the overall percentage of MBE participation relative to total contract value. Alternatively, if a vendor cannot meet the 23% goal despite good faith outreach efforts, the form permits submission of a waiver with documentation of contact attempts to at least three MBE firms, including their names, business addresses, and phone numbers. All submissions must be signed by an authorized firm representative and include the firm's complete contact information.
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Other files
| File | Type | Posted |
|---|---|---|
| 27-14 Supply of Towels for Members of CA Sport and Fitness Facilities .pdf | ||
| 27-14 REFERENCES.docx | DOCX document |
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Text version
COLUMBIA ASSOCIATION
MINORITY BUSINESS ENTERPRISE (MBE) FORM
Solicitation Title: SUPPLY OF TOWELS FOR MEMBERS OF ca Sport and Fitness Facilities Solicitation Number: 27-13
Instructions: The Minority Business Enterprise (MBE) Form must be submitted with the bid/proposal. Failure to accurately complete and submit this form may deem the bid unresponsive or may determine that the proposal cannot be selected for contract award.
1. The Vendor shall attempt to achieve twenty three percent (23%) or greater participation from certified Minority Business Enterprise firms for the performance of this contract, in accordance with CA’s organizational goal. This may be in the form of a prime or subprime participation.
2. The Vendor is encouraged to use a diverse group of subcontractors and suppliers from the various MBE classifications. All MBE firms must be certified as specified in the Minority Business Enterprise paragraph of this solicitation. Only certified MBE firms shall be counted toward this requirement. Firms may obtain a listing of certified Minority Business Enterprise firms from the Maryland Department of Transportation (MDOT) directory which can be found through the following link: https://mbe.mdot.maryland.gov/directory/
In connection with the bid/proposal submitted in response to Solicitation No. _______________, I affirm the following:
☐ I acknowledge and intend to meet IN FULL the overall certified Minority Business Enterprise (MBE) participation goal of twenty three percent (23%). For each MBE firm utilized the proposer must provide the following information to include a copy of the MBE firm’s certification documentation, the MBE firm’s name, address and tax identification number.
| Total African American MBE Participation: | $_____________ | |
| Total Asian American MBE Participation: | $_____________ | |
| Total Hispanic American MBE Participation: | $_____________ | |
| Total Women-Owned MBE Participation: | $_____________ | |
| Total Disabled MBE Participation: | $_____________ |
| Total MBE Participation (include all categories): | $_____________ | ||
| Total Contract Value: | $_____________ | ||
| Total Percentage of MBE Participation | ____________% |
OR
☐ After making good faith outreach efforts prior to making this submission, I conclude that I am unable to achieve the MBE participation goal. Firm must provide the name, business address and phone number of all Minority Business Enterprise firms that were contacted to provide goods or services under this contract. At least three firms must be listed.
1. _____________________________________________________________
2. _____________________________________________________________
3. _____________________________________________________________
I affirm that I have reviewed this form and certify that the information provided is true to the best of my knowledge, information and belief.
Firm Name: _________________________________ Date: ________________________
Signature of Authorized Firm Representative: ____________________________________
Printed Name and Title: _____________________________
Phone (_____) _______ - ___________
Address: ____________________________________________________________________
E-mail: _____________________________________________________________________
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