8-H. MWSBE Utilization Form.pdf

PDF 183 KB Posted

Attached to
Water Treatment Plant Valve Replacement Materials
Solicitation number
FY26-ITB-04
Issued by
Mecklenburg County, Charlotte City, North Carolina

About this file

This document is a Required Form for M/W/SBE (Minority/Women/Small Business Enterprise) Utilization from the City of Charlotte, specifically the Charlotte Business Inclusion program. The form is designed to support the city's commitment to including diverse businesses in the contracting and procurement process by requiring bidders to outline potential subcontracting opportunities with City-certified Small Business Enterprises (SBE), Minority-owned Business Enterprises (MBE), and Woman-owned Business Enterprises (WBE).

The form requires bidders to indicate their own business classification, provide details about certification with affiliated agencies, and document outreach efforts to maximize inclusion of MWSBEs both in the bid submission and during the contract period. Bidders must list intended subcontractors, including their names, work descriptions, business classification (M/W/S), and city vendor number. The form also requires calculation of total utilization percentages for MBE, WBE, SBE, and overall MWSBE participation, with space for the representative's signature, date, and the estimated total contract value.

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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:

[Form continues on next page]

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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