4-RFP-05-Small Business Utilization Form.pdf
PDF 200 KB Posted
- Attached to
- RFP Commerce Street Development
- Solicitation number
- 26-0159
- Issued by
- Tarrant County, Texas
About this file
This is a Small Business Utilization Form from the City of Fort Worth related to the RFP Commerce Street Development procurement. The form is mandatory for all bidders participating in this contract opportunity and establishes the City's commitment to small business participation in the project. Bidders must complete the form in its entirety and provide current certification documentation for all small businesses to be credited toward the small business goal; failure to do so may result in zero points awarded for small business criteria and evaluation based solely on remaining best value criteria.
The City of Fort Worth has established a 30% small business goal for this procurement, which may be met through prime contractor self-performance as a certified small business, utilization of one or more certified small business subcontractors, or a combination of both. A small business is defined as a business entity located in Tarrant, Wise, Johnson, Parker, or Denton County holding current certification from an organization approved by the City Manager. Bidders must list all subcontractors and suppliers designated to meet the small business goal, including their legal names, addresses, contact information, types of services, NAICS codes, dollar amounts, and certifying agencies. Bidders who are awarded the contract must execute formal agreements with each small business subcontractor or supplier listed on the form. By submitting the signed form, bidders agree to provide complete and accurate information regarding actual work performed by subcontractors, permit audits of books and records, and allow interviews with company principals and subcontractors to substantiate work performed. Bidders who intentionally misrepresent material facts may be disqualified from consideration on future City bids.
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Text version
City of Fort Worth Small Business Utilization Form
10.1.2025-V1
The City of Fort Worth has set a Small Business Goal of 30% for this procurement. That goal may be met by self-performance by a prime contractor that is a certified Small Business, utilization of one or more subcontractors that are certified Small Businesses, or a combination of both.
ALL BIDDERS MUST COMPLETE THIS FORM.
ALL SMALL BUSINESS FIRMS MUST BE CERTIFIED PRIOR TO SUBMITTING A BID SUBMISSION.
A Small Business means a business entity that is located in Tarrant, Wise, Johnson, Parker or Denton County and that holds current certification as a small business from an organization approved by the City Manager for each commodity and service code listed. A copy of the current certification for each Small Business (including Bidder, if a Small Business seeking credit for self-performance) must be submitted with the bid.
Failure to (i) complete this form in its entirety or (ii) submit a current valid certification for all Small Businesses to be used with this Bid/Offer may result in zero points being awarded with respect to the Small Business Goal criteria during bid evaluation and with the bid being awarded points based solely on the remaining best value criteria.
If the undersigned Bidder is awarded a contract for this procurement, the Bidder must execute a formal agreement with each Small Business that Bidder uses as a subcontractor or supplier that is listed on this form.
Please list all subcontractors and suppliers being utilized to meet the Small Business Goal for this procurement.
Please list certified Small Business firm names as listed on their certification, including DBA names.
Contractors/Suppliers Legal Name
Address Contact information:
Name/Phone/Email
Types of Services
NAICS
Code(s)
$ Amount Certifying Agency
Address Contact information:
Name/Phone/Email
Types of Services
NAICS
Address Contact information:
Name/Phone/Email
Types of Services
NAICS
BIDDER LEGAL NAME:
Bid Name: Bid Number:
Certifying Agency:
City’s Small Business Goal is 30% if Bidder would like to commit to a higher percentage, please provide % Are you a certified Small Business Enterprise
(SBE)?
Yes No
City of Fort Worth Small Business Utilization Form
10.1.2025-V1
By affixing a signature to this form, Bidder further agrees to provide, directly to the City upon request, complete and accurate information regarding actual work performed by all subcontractors. The Bidder also agrees to allow an audit and/or examination of any books, records, and files held by their company related to the job being bid and/or the subcontractors being utilized. The Bidder agrees to allow and facilitate interviews by an authorized officer or employee of the City with owners, principals, officers, employees, and applicable subcontractors/suppliers participating on the contract in order to substantiate the actual work performed by the Small Business(es) under this contract.
A Bidder who intentionally and/or knowingly misrepresents material facts may no longer be considered a responsible bidder and therefore disqualified from consideration with respect to future City bids.
Legal Company Name: ___________________________________________________
Authorized Signature: ____________________________________________________
Printed Name: __________________________________________________________
Title: __________________________________________________________________
Address (Street, City, State, Zip): ____________________________________________
Phone Number: __________________________________________________________
Email address: ___________________________________________________________
Total Dollar Amount of Bidder Services towards small business goal
Total Dollar Amount of Small Business Subcontractors $
Total Dollar Amount of Non-Small Business Subcontractors $
TOTAL DOLLAR AMOUNT $
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