5-MBE_Utilization_Form.docx
DOCX document 24 KB Posted
- Attached to
- Animal Shelter Renovation and Addition
- Solicitation number
- 2026-ITB-359
- Issued by
- New Haven County, Connecticut
About this file
This is a Minority Business Enterprise (MBE) Utilization Documentation form required by the City of New Haven, Connecticut for the Animal Shelter Renovation and Addition project. The form mandates that all contractors submit a complete listing of subcontractors to be used on the project, including company names, addresses, types of work, dollar amounts, outreach methods used to secure the subcontractors, and appropriate company classifications. The submission of this form is mandatory and constitutes a requirement for responsive bids; failure to complete and submit the form will result in rejection of the contractor's response. The project scope encompasses renovation and addition work at an existing animal shelter, including concrete trenching and patching, masonry modifications, plumbing, HVAC, and electrical modifications, as well as interior renovations to restrooms, break room, cat isolation room, laundry, grooming, and disinfection rooms. The addition comprises approximately 700 square feet of cast-in-place concrete construction with wood joist roof framing, and exterior work includes concrete sidewalks and chain-link fencing.
The City of New Haven has established a minimum participation goal of 25 percent for minority and women-owned small businesses on this project. Contractors must certify that they have reviewed the city's MBE and WBE goals and have achieved the required 25 percent participation level through their subcontractor selections. The form requires documentation of outreach efforts used to identify and select minority-owned businesses (MBE) and women-owned businesses (WBE) as subcontractors, with contractors providing signatures and dates of authorization by the city's relevant department. This documentation serves as evidence of good faith efforts to meet the established participation requirements for disadvantaged business enterprises.
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Text version
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 .