5-BEH-FRM-604.SAW Local Participation Workforce Impact.docx

This is a Local Participation and Workforce Impact certification form (BEH-FRM-604.SAW) issued by the City of Dallas, Texas, for use in connection with the Pension Investment Monitoring and Advisory Services solicitation. The form requires prime vendors to provide their legal business name, headquarters address, and local office information if applicable. Vendors must designate a primary contact with name, title, email, and phone number. The form applies to all procurement actions including competitive solicitations, change orders, supplemental agreements, Interlocal Agreements, cooperative purchases, and sole source agreements. The City of Dallas reports vendor location and workforce residency data to City Council as part of its procurement reporting requirements.

The form requires vendors to report total company-wide employees and the number of employees residing within the City of Dallas, with the percentage calculated as a ratio of Dallas-based employees to total employees. Vendors must certify under penalty that all information provided is accurate and complete, acknowledging that the City may verify the data and request supporting documentation during reporting, evaluation, or compliance reviews. False, misleading, or materially incomplete submissions may result in disqualification, scoring adjustments, or other actions permitted under City policy. The certification requires an officer signature, printed name, title, and date, with a revision date of March 19, 2026.