7-H. MWSBE Utilization Form.pdf
PDF 183 KB Posted
- Attached to
- John Bean Sewer Jetter
- Solicitation number
- FY26-ITB-07
- Issued by
- Mecklenburg County, Charlotte City, North Carolina
About this file
This is a Minority/Woman-owned Small Business Enterprise (MWSBE) Utilization Form required by the City for bidders on a procurement for the purchase, delivery, and installation of one (1) John Bean Sewer Jetter for Charlotte Water's Fleet Division in North Carolina. The form requires bidding companies to disclose their own MWSBE certification status, including Minority-owned Business Enterprise (MBE), Woman-owned Business Enterprise (WBE), and Small Business Enterprise (SBE) designations, along with the certifying agency and certification validity dates. Bidders must document their outreach efforts to maximize MWSBE participation both during the bidding process and throughout the contract performance period. The form requires submission with the bid as part of the procurement package.
The form mandates that companies identify all subcontractors providing goods or services, designate their MWSBE classification(s), and calculate total utilization percentages across MBE, WBE, SBE, and combined MWSBE categories. The City maintains a commitment to fostering viable subcontracting opportunities for certified MWSBEs and requires bidders to exhaust all efforts in identifying potential MWSBE participants. The estimated total contract value must be provided, and the authorized company representative must sign and date the completed form, attesting to the accuracy of the MWSBE participation information.
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Text version
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 bid 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
ITB.
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 bid:
Identify outreach efforts that will be employed by the firm to maximize inclusion during the contract period of the Contract:
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Required Forms
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
Estimated Total Contract Value
M/W/SBE UTILIZATION
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