82335AttAMWBE.docx

ATTACHMENT A

MINORITY & WOMEN'S BUSINESS ENTERPRISES RFP SUBCONTRACTOR

COMMITMENT FORM

Indiana Code 4-13-16.5 and 25 IAC 5 governs the Division of Supplier Diversity program as it relates to the certification, oversight, and responsibilities around the certified Indiana Minority and/or Women Business Enterprises (MWBE). As stated in Section 1.18, a commitment expectation for this solicitation. The MWBE Subcontractor Commitment form is Attachment A. If opting to propose a commitment, the MWBE Subcontractor Commitment Form is to be submitted as a part of the Respondent’s proposal. The entity must be on the State of Indiana Certified M/W/IVOSB list at https://www.in.gov/idoa/mwbe. The State will not follow up with the Respondent if the subcontracting opportunities are not submitted.

If participation is proposed through the use of Subcontractors, the Respondent must provide the scope of work of the products and/or services to be provided by the Subcontractor(s). This must include explanation of whether the products and/or services are to be utilized directly by the Respondent and/or directly by the State, a description of the process through which the products/services will be received and applied to the benefit of the award, the deliverable requirements as agreed upon between the Contractor and Subcontractor, the certified UNSPSC that applies to the award, and the cost of supplies being utilized by the Respondent for this proposal. Respondents must complete the Subcontractor Commitment Form in its entirety. The amount entered in “TOTAL BID AMOUNT” should match the amount entered in the Attachment D, Bid Cost Template, Total Bid Cost tab, cell H13.

Failure to meet these goals will not affect the evaluation of your Proposal. The Department will verify certification information included on the MWBE Subcontractor Commitment Form.

Prime Contractors must ensure that the proposed Subcontractors meet the following criteria:

· Must be on the State of Indiana Certified M/W/IVOSB list at https://www.in.gov/idoa/mwbe, on or before the bid response due date.

· Each firm may only serve as one classification – MBE, WBE, or IVOSB (see section 1.18).

· MWBE must have a Bidder ID

· MWBE must provide goods or service only in the industry area for which it is certified. Specify the certified code on Attachment A that applies to the contract from https://www.in.gov/idoa/mwbe.

· Must be used to provide the goods or services specific to the award.

· National Diversity Plans are generally not acceptable.

MINORITY & WOMEN’S BUSINESS ENTERPRISES RFP SUBCONTRACTOR LETTER OF COMMITMENT (MWBE)

A signed letter(s), on company letterhead, from the MBE(s) and/or WBE(s) must accompany the MWBE Subcontractor Commitment Form. Each letter shall state and will serve as acknowledgement from the MBE and/or WBE of its subcontract amount, a description of products and/or services to be provided on this project, and approximate date the Subcontractor will perform work on this contract.

By submission of the proposal, the Respondent acknowledges and agrees to be bound by the rules and requirements of the State’s Division of Supplier Diversity. Questions about those rules and requirements should be directed to: Division of Supplier Diversity at (317) 232-3061 or the Supplier Diversity website at https://www.in.gov/idoa/mwbe.

STATE OF INDIANA MBE/WBE SUBCONTRACTOR COMMITMENT FORM

NB#:25-82335

TOTAL BID AMOUNT:

r MBE Firm r WBE Firm

Company Name:

Contact Person:

Address:

E-mail:

Telephone Number:

Fax Number:

Sub-Contract Amount:

Sub-Contract Percentage of Total Bid:

Describe service/product to be provided and how this is a Valuable Scope Contribution of the Contract. Include the applicable certified UNSPSC that applies to this commitment.

Provide approximate dates when Sub-Contractor will perform on this project:

r MBE Firm r WBE Firm

Company Name:

Contact Person:

Address:

E-mail:

Telephone Number:

Fax Number:

Sub-Contract Amount:

Sub-Contract Percentage of Total Bid:

Describe service/product to be provided and how this is a Valuable Scope Contribution of the Contract. Include the applicable certified UNSPSC that applies to this commitment.

Provide approximate dates when Sub-Contractor will perform on this project:

Respondent Firm

Telephone Number

Address

Fax Number

City/State/Zip Code

Email Address

Representative

Authorizing Signature

Date

Printed Name and Title

· Please check if additional forms are attached.

Page ________ of __________

FORM MUST BE COMPLETED IN ITS ENTIRETY WITH COMPLETED LETTERS OF COMMITMENT.