5-PA1858 Final Schedule of Subcontractors.pdf

Exhibit B

SCHEDULE OF SUBCONTRACTORS (FINAL)

Prime Bidder/Contractor:_______________________________________________________________________________

MBE WBE NON-M/WBE

Contract Number: _______________________ Contract Name:____________________________________________________________________________________

As part of the procedures for the submission of a completed bid/proposal, all bidders/proposers are required to identify ALL participating subcontractors applicable to the above project and include this completed form as part of the bid. Check all Certification Status categories that apply to each subcontractor. Verify that the proposed M/WBE subcontractor has a place of business in the Airport’s Relevant Market Area3 (not applicable to DBE goals). NOTE: Certification certificate(s) MUST be attached to this form or bid/proposal will be deemed non-responsive. The submission of this information is considered an issue of responsiveness, and the Airport Board will not award a contract to any Contractor who has not supplied this documentation. Use additional sheets if necessary.

Certification Status2

(check the applicable) Relevant

Market Area3 Description of Material or Service

Being Provided or Performed

NAICS

Commodity Code Dollar Amount and Percentage of Work

Name of Subcontractor(s)

MBE WBE NON COUNTY $$$ %

Dollar Amount & Percentage: Work to be completed by Non-MWBE Subcontractors Dollar Amount & Percentage: Work to be completed by M/WBE Subcontractors Dollar Amount & Percentage: Work to be self-performed by the Prime Total Dollar Amount & Percentage of Work (The Total Amount shall equal the amount proposed on summary of bid/proposal page).

100%

PRIME CONTRACTOR’S CERTIFICATION

The above information is true and complete to the best of my knowledge and belief. I further understand and agree that if awarded the contract, this certification shall be attached thereto and become a part thereof. Failure to provide accurate and complete information or exercise positive, good faith efforts (as defined by the Board’s M/WBE Program) in support of the Board’s minority/woman-owned business intent and objective may result in being considered non-responsive to the Board’s requirements. Furthermore, it is understood and agreed that, if awarded a contract by the Airport Board, the Contractor will not make additions, deletions or substitutions to this certified list of M/WBE subcontractors without the consent of the Board’s Vice President of Business Diversity & Development Department (BDDD) or designee through the submittal of the Form 102, Request for Approval of Change to Final Schedule of Subcontractors if this is determined to be the final schedule. The BDDD reserves the right to ensure compliance with the Board’s M/WBE programs as deemed necessary including but not limited to audits of submitted M/WBE information applicable to the Contractor/subcontractors participating on the contract.

Name and Title of Authorized Representative_____________________________________________________________ Date:_____________________________________ (Please print or type)

Signature:_________________________________________________________________________________________ E-mail Address:___________________________________

Any named person, firm, partnership, corporation, association or joint venture as herein provided identified as providing work, labor, services, supplies, equipment, materials or any combination of the foregoing, under contract to a prime Contractor on an Airport contract at any tier.

2 In order to credit the participation of minority and woman-owned businesses, firms must be certified as M/WBEs by a certification agency approved by the Airport Board as defined in the M/WBE Policies and Administrative Procedures.

3 In addition to having a valid certification, the M/WBE must have a place of business in the Airport’s relevant market area at the time the bid/proposal is submitted for credit towards meeting an M/WBE goal.

Instructions for Schedule of Subcontractors

(Note: This form requires the prime contractor to sign and date prior to bid/proposal submission.)

Name of Prime Bidder/Contractor: Enter name of company bidding or proposing and certification status (MBE, WBE, Non-M/WBE).

Contract Number: Enter the reference number or solicitation number from the Bonfire portal.

Contract Name: Enter the Project name from the Bonfire portal.

List all subcontractors and suppliers the Prime Bidder/Contractor intends to use in performing the work of the project, including non-M/WBEs. Only certified M/WBEs identified, and the levels of participation listed for each at the time of bid/proposal submission will be considered in determining whether the Contractor has met the M/WBE goal.

Name of Subcontractor(s): Enter the name of the proposed subcontractor. This includes subconsultants and suppliers.

Certification status: Select the certification status of the proposed subcontractor. (MBE, WBE or NON-M/WBE) Relevant Market Area: Enter the name of the county where the M/WBE subcontractor’s physical place of business is located. The Airport’s Relevant Market Area consists of Collin, Dallas, Denton and Tarrant counties only.

Description of Material or Service Being Provided or Performed: Provide a brief description of the work that will be performed by the subcontractor.

NAICS Commodity Code: Enter the NAICS code(s) that correspond to the description of material or service being provided or performed by the subcontractor.

Dollar Amount and Percentage of Work:

• Request for Bids (RFB): Enter the subcontractor/supplier dollar amount and associated percentage of work to be performed by the M/WBE subcontractor/supplier. The percentage should be calculated against the Prime Contractor’s total dollar amount bid. The dollar amount and percentage must match the dollar amount and percentage noted on the Intent to Perform as an M/WBE Subcontractor form, if the Intent to Perform form is applicable).

• Request for Proposals (RFP): Note the Price as Not Applicable or N/A. Enter the percentage of work to be performed by the M/WBE subcontractor/supplier. The percentage should be calculated against the Prime Contractor’s total percentage proposed (100%). The percentage must match the percentage noted on the on the Intent to Perform as an M/WBE Subcontractor form, if the Intent to Perform form is applicable).

Dollar Amount & Percentage: Work to be completed by Non-MWBE: If RFB, enter the subtotal dollar amount and percentage of work to be performed by Non-M/WBE subcontractors. If RFP, enter percentage only.

Dollar Amount & Percentage: Work to be completed by M/WBE Subcontractors: If RFB, enter the subtotal dollar amount and percentage of work to be performed by certified M/WBE subcontractors. If RFP, enter percentage only.

Dollar Amount & Percentage: Work to be self-performed by the Prime: If RFB, enter the subtotal dollar amount and percentage of work to be performed by the prime bidder/contractor.

If RFP, enter percentage only.

Total Dollar Amount & Percentage of Work: Enter the TOTAL dollar amount and percentage of work. The total dollar amount shall equal the amount proposed on the summary of bid/proposal page. The total percentage of work must equal to 100% (% Work to be performed by non-M/WBE subcontractors + % M/WBE subcontractors + % prime bidder/contractor self-performance)

Name and Title of the Authorized Representative: Enter the full name and title of the authorized representative signing on behalf of the company.

Date: Enter date of executed Authorized Representative signature.

Signature: The authorized representative must sign this form.

Email Address: Enter the email address for the authorized representative.

NOTE: Sample forms available for reference at:

https://www.dfwairport.com/business/opportunities/bdd/ > Business Resources https://www.dfwairport.com/business/opportunities/bdd/