5-3. Exhibit A-2 Utilization Plan 0% (2022).pdf
PDF 330 KB Posted
- Solicitation number
- 2026-02
- Issued by
- Erie County, New York
About this file
This is an M/WBE Utilization Plan form issued by Erie County Medical Center Corporation (ECMCC) in New York for the removal and replacement of a 5,000-gallon underground storage tank (UST Diesel Tank #13). The form must be submitted with any proposal or within 48 hours of notice that the respondent is the apparent lowest responsible bidder to the IFB 2026-02. The project involves comprehensive labor, equipment, and materials for tank cleaning, removal, installation, and site restoration at 462 Grider Street, Buffalo, New York 14215, with a project duration of 120 calendar days from the Notice to Proceed. The bid submission deadline is Monday, June 8, 2026, and bids remain open for acceptance for 45 days following bid opening. Contractors must commence work within five calendar days of the Notice of Award and Agreement execution and submit signed agreements, bonds, and supporting documentation within ten days of the Owner's Notice of Award.
The M/WBE goals for this contract are established at 0%, meaning no minority-owned business enterprise or women-owned business enterprise utilization requirements or set-asides apply to this procurement. The form requires offerors to list certified M/WBE subcontractors and suppliers, including their names, addresses, classifications, Federal Identification Numbers, detailed descriptions of work, and dollar values or percentages of subcontracts and supplies, though such utilization is not mandated due to the 0% goal. The form must be completed with signature and date of the preparer and reviewed by ECMCC M/WBE personnel, with approval indicated as yes or no. No incumbent vendor or current contractor has been identified in the procurement documents. Submission of the form constitutes the offeror's acknowledgement and agreement to comply with M/WBE requirements under NYS Executive Law Article 15-A and 5 NYCRR Part 143, and failure to submit complete and accurate information may result in noncompliance findings, bid rejection, or contract termination.
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Text version
MWBE Utilization Plan rev 5/22
EXHIBIT A-2 M/WBE UTILIZATION PLAN
INSTRUCTIONS: This form must be submitted with any proposal or proposed negotiated contract or within 48 hours of notice from ECMCC that the respondent is the apparent lowest responsible bidder to an IFB. This Utilization Plan must contain a detailed description of the supplies and/or services to be provided by each certified Minority or Women-
Owned Business Enterprise (MWBE) under the contract. Attach additional sheets if necessary.
Federal Identification No.: ___________________________________________
Location of Work: __________________________________________________
RFP or Bid No.: __________________________________________________
M/WBE Goals in the Contract: 0%
Offeror’s Name: _____________________________________________________
Address: __________________________________________________________
City, State, Zip Code: _________________________________________________
Telephone Number: __________________________________________________
NYS Contract System Identification No: ________________________________
NYS Contract System point of contact User: ____________________________
Contract Value: ____________________________________________________
1. Certified M/WBE Subcontractors/Suppliers
Name, Address, Email Address, Telephone No.
2. Classification 3. Federal ID No. 4. Detailed Description of Work (Attach additional sheets, if necessary)
5. Dollar Value or percentage of
Subcontracts/
Supplies/Services
1. NYS ESD CERTIFIED
MBE
WBE
2. NYS ESD CERTIFIED
MBE
WBE
3. NYS ESD CERTIFIED
MBE
WBE
4. NYS ESD CERTIFIED
MBE
WBE
5. NYS ESD CERTIFIED
MBE
WBE
MWBE Utilization Plan rev 5/22
6. NYS ESD CERTIFIED
MBE
WBE
7. NYS ESD CERTIFIED
MBE
WBE
8. NYS ESD CERTIFIED
MBE
WBE
PREPARED BY (Signature):
DATE:
NAME AND TITLE OF PREPARER (Print or Type):
SUBMISSION OF THIS FORM CONSTITUTES THE OFFEROR’S ACKNOWLEDGEMENT AND AGREEMENT TO
COMPLY WITH THE M/WBE REQUIREMENTS SET FORTH UNDER NYS EXECUTIVE LAW, ARTICLE 15-A, 5 NYCRR PART 143, AND THE ABOVE-REFERENCED SOLICITATION. FAILURE TO SUBMIT COMPLETE AND
ACCURATE INFORMATION MAY RESULT IN A FINDING OF NONCOMPLIANCE AND/OR REJECTION OF YOUR
BID/PROPOSAL AND/OR POSSIBLE TERMINATION OF YOUR CONTRACT. UTILIZATION OF CERTIFIED MWBES
FOR NON-COMMERCIALLY USEF FUNCTIONS MAY NOT BE COUNTED TOWARD MWBE REQUIREMENTS.
TELEPHONE NO.: EMAIL ADDRESS:
FOR ECMCC M/WBE USE ONLY
REVIEWED BY: DATE:
UTILIZATION PLAN APPROVED: YES NO Date:
Contract No.: Project No. (if applicable):
Contract Award Date:
Estimated Date of Completion:
Amount Obligated Under the Contract:
Description of Work:
NOTICE OF DEFICIENCY ISSUED: YES NO Date:______________
NOTICE OF ACCEPTANCE ISSUED: YES NO Date:_____________
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