4-Exhibit E-3 Monthly DIB Utilization Report.docx
DOCX document 42 KB Posted
- Solicitation number
- RFP-25-002
- Issued by
- Los Angeles County, California
About this file
This document is a Monthly Diversity in Business Utilization Report template for the Water Replenishment District of Southern California, designed to track subconsultant participation and diversity goals for a contract. The template is structured to capture comprehensive details about prime consultants and subconsultants, including their business certifications, contract amounts, invoiced amounts, and diversity status across multiple business categories such as local business, small business, and disabled veteran business enterprises.
The report requires detailed tracking of each subconsultant's role, total contract amount, amount invoiced during the reporting period, total paid to date, remaining contract amount, and specific diversity classifications. It includes sections for certifying the accuracy of the information under penalty of perjury, with space for signatures, names, titles, and dates. The template is specifically linked to a related Request for Proposals (RFP) for SCADA System Integration, Support and Maintenance Services, indicating it is part of a broader procurement process for technical services in California.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 1-WRD - RFP-25-002 - SCADA Integration and Maintenance Services.pdf | ||
| 3-Exhibit E-2 DIB Participation Report.docx | DOCX document | |
| 2-Exhibits E-1 and E-2 Diversity in Business Tables RFP-25-002.xlsx | XLSX spreadsheet |
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Text version
MONTHLY DIVERSITY IN BUSINESS UTILIZATION REPORT
Water Replenishment District of Southern California
GENERAL INFORMATION
Project Name:
Contract Number:
| Report No.: |
| Reporting Period: |
| to |
| Diversity in Business Participation Goal: |
| Contract Completion Date: |
| Prime Consultant: |
| Project Manager: |
Prime Consultant Address, Telephone No., and E-mail:
Prime Consultant must list all certified and non-certified subconsultants that will be utilized for the entire contract period in the table below and update the utilization of each Consultant and subconsultant listed below on a monthly basis.
| ROLE |
| BUSINESS NAME |
| DESCRIPTION OF WORK |
| PROFILE INFORMATION |
| TOTAL AMOUNT OF CONTRACT |
| AMOUNT INVOICED DURING REPORTING PERIOD |
| TOTAL PAID TO DATE |
| TOTAL CONTRACT AMOUNT REMAINING |
| DIVERSITY IN BUSINESS AMOUNT |
| NON- DIVERSITY IN BUSINESS |
AMOUNT
Prime Consultant
| Certification | Cert. Agency | NAICS | |
| Cert. Expiration: | Local Business: Yes No Small Business: Yes No Disabled Veteran Business: |
Yes No
Subconsultant
| Certification | Cert. Agency | NAICS | |
| Cert. Expiration: | Local Business: Yes No Small Business: Yes No Disabled Veteran Business: |
| ROLE |
| BUSINESS NAME |
| DESCRIPTION OF WORK |
| PROFILE INFORMATION |
| TOTAL AMOUNT OF CONTRACT |
| AMOUNT INVOICED DURING REPORTING PERIOD |
| TOTAL PAID TO DATE |
| TOTAL CONTRACT AMOUNT REMAINING |
| DIVERSITY IN BUSINESS AMOUNT |
| NON- DIVERSITY |
IN BUSINESS AMOUNT
Subconsultant
| Certification | Cert. Agency | NAICS | |
| Cert. Expiration: | Local Business: Yes No Small Business: Yes No Disabled Veteran Business: |
Subconsultant
| Certification | Cert. Agency | NAICS | |
| Cert. Expiration: | Local Business: Yes No Small Business: Yes No Disabled Veteran Business: |
Subconsultant
| Certification | Cert. Agency | NAICS | |
| Cert. Expiration: | Local Business: Yes No Small Business: Yes No Disabled Veteran Business: |
Subconsultant
OBE
Subconsultant
Subconsultant
| ROLE |
| BUSINESS NAME |
| DESCRIPTION OF WORK |
| PROFILE INFORMATION |
| TOTAL AMOUNT OF CONTRACT |
| AMOUNT PAID DURING REPORTING PERIOD |
| TOTAL PAID TO DATE |
| TOTAL CONTRACT AMOUNT REMAINING |
| DIVERSITY IN BUSINESS AMOUNT |
| NON- DIVERSITY |
IN BUSINESS AMOUNT
Subconsultant
Subconsultant
Subconsultant
MONTHLY SUMMARY TOTAL AMOUNT
The undersigned certifies and declares under penalty of perjury under the laws of the State of California that the information contained herein is true and correct to the best of my knowledge.
Signature Date
Name (Please Print) Title
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