5-MBE_Utilization_Form.docx

DOCX document 24 KB Posted

Attached to
On Call Security Systems Maintenance and Repair for NHPS
Solicitation number
2026-HYRFP-CNH-324
Issued by
New Haven County, Connecticut

About this file

This is an MBE Utilization Form from the City of New Haven required for the On-Call Security Systems Maintenance and Repair contract with New Haven Public Schools (NHPS) in Connecticut. The form mandates that contractors submit a complete list of all subcontractors to be used on the project, including company name, address, type of work, dollar amount, outreach method used to secure the subcontractor, and appropriate company classification. Contractors must certify that they have read the City of New Haven's goals for minority and women-owned small business utilization and have achieved the required 25% participation goal. The form requires contractor signature, printed name and title, date, and approval by the City's relevant department or office. Submission of a completed form is mandatory; any submission lacking this documentation will be deemed non-responsive and rejected.

The form establishes a minority and women-owned business enterprise participation requirement of 25% for the contract. Contractors must document their outreach efforts and identify whether subcontractors meet MBE (minority business enterprise) or WBE (women business enterprise) classifications. The form serves as a compliance and accountability mechanism to ensure that qualified minority and women-owned businesses receive meaningful participation opportunities on the NHPS security systems maintenance and repair project.

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City of New Haven MBE Utilization Documentation – Sub-Contractor Listing Project Name and ID:

The Contractor herewith submits a complete list of all Subcontractors to be used on the project by name address, type of work, dollar amount, outreach method used to secure subcontractor and appropriate company classification. This form must be completed as part of your submission. Your submission will be deemed non-responsive if the form is not completed and your response will be rejected.

I am representing Certify that I have read the City of New Haven's goals Name Company for use of minority and women owned small businesses and I have achieved the Goal of 25% participation.

Signature Type Name & Title Date Approved by S

CD

- Signature Print Name and Title Date

Name of Contractor
Address
Telephone
Contact
Type of Work
Dollar

Amount Type of Outreach

MBE
WBE

Rev 9/25/2024[DOCUMENT TITLE] | [Document subtitle]

File details come from the government source that posted it. Updated .