9-4. ECMCC-Exhibit A-3-SDVOB 0% (2024).pdf

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Attached to
UST DIESEL TANK #13 5000 GALLON REMOVAL & REPLACE
Solicitation number
2026-02
Issued by
Erie County, New York

About this file

This is a Service-Disabled Veteran-Owned Business (SDVOB) Utilization Plan form required by Erie County Medical Center (ECMCC) for a contract opportunity involving the removal and replacement of a 5,000-gallon underground storage tank (UST). The form must be submitted with any proposal or negotiated contract, or within 48 hours of notice that the respondent is the apparent lowest responsible bidder to an invitation for bid (IFB). The project scope includes all labor, equipment, and materials necessary for tank cleaning, removal, installation, and site restoration. The contract carries an SDVOB goal of 0% utilization.

The SDVOB Utilization Plan requires respondents to provide detailed information on any certified Service-Disabled Veteran-Owned Business subcontractors or suppliers, including their names, addresses, contact information, federal identification numbers, descriptions of work to be performed, and dollar values or percentages of subcontracted supplies and services. Submission of the completed form constitutes acknowledgment and agreement to comply with SDVOB requirements under New York State Executive Law, Veteran's Service Law Article 3, and 9 NYCRR Part 252. Failure to submit complete and accurate information may result in findings of noncompliance, bid rejection, or contract termination. The form includes sections for ECMCC review and approval, with space to document notices of deficiency or acceptance and relevant contract details including award date, estimated completion date, and total amount obligated.

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Text version

SDVOB Utilization Plan rev 1/24

EXHIBIT A-3

SDVOB UTILIZATION PLAN

INSTRUCTIONS: This form must be submitted with any proposal or proposed negotiated contract or within 48 hours of notice from ECMCC that the respondent is the apparent lowest responsible bidder to an IFB. This Utilization Plan must contain a detailed description of the supplies and/or services to be provided by each certified Service-Disabled

Veteran-Owned Business (SDVOB) under the contract. Attach additional sheets if necessary.

Respondent’s Name: _____________________________________________________ RFP or Bid No.: __________________________________________________

Federal Identification No.: ___________________________________________ SDVOB Goals in the Contract: 0%

Contract Value: ____________________________________________________

1. Certified SDVOB Subcontractors/Suppliers

Name, Address, Email Address, Telephone No.

2. Federal ID

No.

3. Detailed Description of Work

(Attach additional sheets, if necessary)

4. Dollar Value or percentage of

Subcontracts/

Supplies/Services

1.

2.

3.

4.

5.

6.

SDVOB Utilization Plan rev 1/24

7.

8.

PREPARED BY (Signature):

DATE:

NAME AND TITLE OF PREPARER (Print or Type):

SUBMISSION OF THIS FORM CONSTITUTES THE OFFEROR’S ACKNOWLEDGEMENT AND AGREEMENT TO COMPLY WITH THE SDVOB REQUIREMENTS SET FORTH UNDER NYS EXECUTIVE LAW, VETERAN’S SERVICE

LAW ARTICLE 3, 9 NYCRR PART 252, AND THE ABOVE-REFERENCED SOLICITATION. FAILURE TO SUBMIT

COMPLETE AND ACCURATE INFORMATION MAY RESULT IN A FINDING OF NONCOMPLIANCE AND/OR REJECTION OF YOUR BID/PROPOSAL AND/OR POSSIBLE TERMINATION OF YOUR CONTRACT. UTILIZATION OF

CERTIFIED SDVOB’s FOR NON-COMMERCIALLY USEFUL FUNCTIONS MAY NOT BE COUNTED TOWARD SDVOB

REQUIREMENTS.

TELEPHONE NO.:

EMAIL ADDRESS:

FOR ECMCC SDVOB USE ONLY

REVIEWED BY:

DATE:

UTILIZATION PLAN APPROVED: YES NO Date:

Contract No.: Project No. (if applicable):

Contract Award Date:

Estimated Date of Completion:

Amount Obligated Under the Contract:

Description of Work:

NOTICE OF DEFICIENCY ISSUED: YES NO Date:______________

NOTICE OF ACCEPTANCE ISSUED: YES NO Date:_____________

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