5-E. Bonfire MWSBE Utilization Form.docx
DOCX document 39 KB Posted
- Attached to
- Siphon Cleaning Services
- Solicitation number
- FY26-RFP-11
- Issued by
- Mecklenburg County, Charlotte City, North Carolina
About this file
The document is a Minority/Women/Small Business Enterprise (MWSBE) Utilization Form from the City of Charlotte, associated with a sanitary sewer siphon cleaning services contract for Charlotte Water. The form is designed to encourage and track the inclusion of certified minority-owned (MBE), women-owned (WBE), and small business enterprises (SBE) in the city's contracting process. The related contract opportunity involves an annual sanitary sewer siphon cleaning program aimed at optimizing system performance and preventing sanitary sewer overflows, with the goal of cleaning each siphon in the collection system at least once per year.
The form requires vendors to self-identify their business classification (MBE, WBE, SBE, or none), provide certification details, and outline their outreach efforts to maximize MWSBE inclusion both during the proposal submission and throughout the contract period. Vendors must list potential MWSBE subcontractors, describing their work, materials, and business classification, and calculate total utilization percentages for each business category. The document reflects the city's commitment to promoting diversity and inclusion in its procurement processes, encouraging companies to make concerted efforts to engage and support minority, women, and small businesses in municipal contract opportunities.
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Required Forms
M/W/SBE UTILIZATION
The City maintains a strong commitment to the inclusion of MWSBEs in the City’s contracting and procurement process when there are viable subcontracting opportunities.
Companies must submit this form with their proposal outlining any supplies and/or services to be provided by each City-certified Small Business Enterprise (SBE), and/or City-registered Minority-owned Business Enterprise (MBE) and Woman-owned Business Enterprise (WBE) for the Contract. If the Company is a City-registered MWSBE, note that on this form.
The City recommends you exhaust all efforts when identifying potential MWSBEs to participate on this RFP.
Company Name:
Please indicate if your company is any of the following:
____ MBE ____WBE ____SBE ____ None of the above If your company has been certified with any of the agencies affiliated with the designations above, indicate which agency, the effective and expiration date of that certification below:
Agency Certifying: _______________________ Effective Date: _________ Expiration Date: _________ Identify outreach efforts that were employed by the firm to maximize inclusion of MWSBEs to be submitted with the firm’s proposal (attach additional sheets if needed):
Identify outreach efforts that will be employed by the firm to maximize inclusion during the contract period of the Project (attach additional sheets if needed):
[Form continues on next page]
List below all MWSBEs that you intend to subcontract to while performing the Services:
| Subcontractor Name |
| Description of work or materials |
| Indicate “M,” “S,” and/or “W” |
| City Vendor # |
| Total MBE Utilization |
| % |
| Total WBE Utilization |
| % |
| Total SBE Utilization |
| % |
| Total MWSBE Utilization |
| % |
| Representative (signed): | ________________________________________________________ |
| _______________ | _____________________________ |
| Date | Representative Name |
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