AAs_Updated_V4.pdf

PDF 520 KB Posted May 24, 2023

Attached to: ASL Interpretation Services
Solicitation number: 2023-Informal-515
Issued by: Los Angeles County, California

About this file

Written by GovTribe AI · May 13, 2025

The document is a set of three forms from the City of Pasadena Purchasing Division related to equal opportunity employment, workforce utilization, and diversity reporting for potential contractors. The forms include a Vendor Questionnaire (Form AA-1), Project Workforce Utilization (Form AA-2), and Current Permanent Workforce Utilization (Form AA-3), which are designed to be submitted as part of the bid process for contracts valued at $25,000 or more. These forms require vendors to provide information about their company's workforce composition, commitment to equal opportunity employment, and potential workforce for a specific project.

The forms are optional and intended for statistical reporting purposes, with the primary goal of ensuring non-discriminatory hiring practices and promoting workforce diversity. The Vendor Questionnaire requires companies to certify that they do not discriminate based on race, religion, color, national origin, ancestry, disability, sex, or age, and do not maintain segregated facilities. The Workforce Utilization forms ask vendors to detail job classifications, existing staff, potential new hires, and the demographic breakdown of their workforce. While completion of some sections is voluntary, the forms aim to collect data that can help the City of Pasadena assess and promote inclusive hiring practices among its contractors.

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Purchasing Division 100 N. Garfield, Room S348 Pasadena, CA 91101 Phone (626) 744-6755 https://www.cityofpasadena.net/finance/doing-business-with-the-city/

Vendor Questionnaire (Form AA-1)

Affidavit of Equal Opportunity Employment & Non-segregation By submitting this form you are declaring under penalty of perjury under the laws of the State of California and the laws of the

United States that the information is true and correct. Furthermore, you are certifying that your firm will adhere to equal opportunity employment practices to assure that applicants and employees are not discriminated against because of their race, religion, color, national origin, ancestry, disability, sex or age. And, your firm does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. Additionally, no employees, consultants, or board members of your company or your subcontractors are current employees of the City of

Pasadena.

Name of Company:

Address:

State:

Contact Person:

Telephone:

E-mail Address:

City:

Zip:

DBA (if applicable):

Remit Address (if different):

Please state clearly and concisely the type(s) of goods and services your company would provide on this contract

Active City of Pasadena Business License Number:

Required For All Public Works: Pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code, you must provide your Registration Number under the Department of Industrial Relations:

Small and Micro Business Preference Program: If certified by California Department of General Services as a small or micro business, please provide DGS Reference Number:

(Visit the Purchasing Division website for additional information):

The following section is OPTIONAL and is for statistical reporting purposes only. Ownership (please check all that apply):

☐African American

☐Asian

☐Armenian

☐Hispanic

☐Native

American

☐Disabled

☐Female https://www.cityofpasadena.net/finance/doing-business-with-the-city/

Pasadena, CA 91101

Phone (626) 744-6755 https://www.cityofpasadena.net/finance/doing-business-with-the-city/

Project Workforce Utilization (Form AA-2)

This form is to be included in all bid documents for projects involving labor or services valued at $25,000 or more.

Instructions: Please indicate the job titles/classifications to be used in the performance of this contract should it be awarded to your firm. Please indicate the number of employees in each job classification as well as the number of new hires, if any, as a result of this contract.

Name of Company: ___________________________________________

Project:___________________________________________

Job Titles/Classification Estimated number of existing staff to be employed in this classification if awarded the contract

Estimated number of new hires to be employed in this classification if awarded the contract

Are any current employees or potential new hires Pasadena residents? If so, how many?

https://www.cityofpasadena.net/finance/doing-business-with-the-city/

Pasadena, CA 91101

Phone (626) 744-6755 https://www.cityofpasadena.net/finance/doing-business-with-the-city/

Current Permanent Workforce Utilization (Form AA-3) (OPTIONAL)

Name of Company: ___________________________________________

Project: ____________________________________________________

Completion of this form is OPTIONAL. Any information supplied by Proposers is for reporting purposes only and will not be factored into the award of any contract.

Instructions: Please indicate the number of employees in each Job Classification belonging to the following groups.

White (not of Hispanic origin)

African-American (not of Hispanic origin)

Hispanic Asian/Pacific Islander

Native American

Armenian Male Female

CLASSIFICATION

Officials/Managers

Professionals

Technicians

Office/Clerical

Skilled Craft Workers

Operators (semi-skilled)

Laborers

Service Workers

TOTAL

https://www.cityofpasadena.net/finance/doing-business-with-the-city/

DBA if applicable:

Remit Address if different:

Please state clearly and concisely the types of goods and services your company would provide on this contract:

Active City of Pasadena Business License Number:

Required For All Public Works Pursuant to Division 2 Part 7 Chapter 1 commencing with section 1720 of the California Labor Code you must provide your Registration Number under the Department of Industrial Relations:

Small and Micro Business Preference Program If certified by California Department of General Services as a small or micro business please provide DGS Reference Number Visit the Purchasing Division website for additional information:

African American: Off

Armenian: Off

Native: Off

Female: Off

Asian: Off

Hispanic: Off

Disabled: Off

Project:

Job TitlesClassificationRow1:

Estimated number of existing staff to be employed in this classification if awarded the contractRow1:

Estimated number of new hires to be employed in this classification if awarded the contractRow1:

Job TitlesClassificationRow2:

Estimated number of existing staff to be employed in this classification if awarded the contractRow2:

Estimated number of new hires to be employed in this classification if awarded the contractRow2:

Job TitlesClassificationRow3:

Estimated number of existing staff to be employed in this classification if awarded the contractRow3:

Estimated number of new hires to be employed in this classification if awarded the contractRow3:

Job TitlesClassificationRow4:

Estimated number of existing staff to be employed in this classification if awarded the contractRow4:

Estimated number of new hires to be employed in this classification if awarded the contractRow4:

Job TitlesClassificationRow5:

Estimated number of existing staff to be employed in this classification if awarded the contractRow5:

Estimated number of new hires to be employed in this classification if awarded the contractRow5:

Job TitlesClassificationRow6:

Estimated number of existing staff to be employed in this classification if awarded the contractRow6:

Estimated number of new hires to be employed in this classification if awarded the contractRow6:

Job TitlesClassificationRow7:

Estimated number of existing staff to be employed in this classification if awarded the contractRow7:

Estimated number of new hires to be employed in this classification if awarded the contractRow7:

Job TitlesClassificationRow8:

Estimated number of existing staff to be employed in this classification if awarded the contractRow8:

Estimated number of new hires to be employed in this classification if awarded the contractRow8:

Job TitlesClassificationRow9:

Estimated number of existing staff to be employed in this classification if awarded the contractRow9:

Estimated number of new hires to be employed in this classification if awarded the contractRow9:

Job TitlesClassificationRow10:

Estimated number of existing staff to be employed in this classification if awarded the contractRow10:

Estimated number of new hires to be employed in this classification if awarded the contractRow10:

Job TitlesClassificationRow11:

Estimated number of existing staff to be employed in this classification if awarded the contractRow11:

Estimated number of new hires to be employed in this classification if awarded the contractRow11:

Estimated number of existing staff to be employed in this classification if awarded the contractAre any current employees or potential new hires Pasadena residents If so how many:

Estimated number of new hires to be employed in this classification if awarded the contractAre any current employees or potential new hires Pasadena residents If so how many:

Project_2:

White not of Hispanic originCLASSIFICATION:

AfricanAmerican not of Hispanic originCLASSIFICATION:

HispanicCLASSIFICATION:

AsianPacific IslanderCLASSIFICATION:

Native AmericanCLASSIFICATION:

ArmenianCLASSIFICATION:

MaleCLASSIFICATION:

FemaleCLASSIFICATION:

White not of Hispanic originOfficialsManagers:

AfricanAmerican not of Hispanic originOfficialsManagers:

HispanicOfficialsManagers:

AsianPacific IslanderOfficialsManagers:

Native AmericanOfficialsManagers:

ArmenianOfficialsManagers:

MaleOfficialsManagers:

FemaleOfficialsManagers:

White not of Hispanic originProfessionals:

AfricanAmerican not of Hispanic originProfessionals:

HispanicProfessionals:

AsianPacific IslanderProfessionals:

Native AmericanProfessionals:

ArmenianProfessionals:

MaleProfessionals:

FemaleProfessionals:

White not of Hispanic originTechnicians:

AfricanAmerican not of Hispanic originTechnicians:

HispanicTechnicians:

AsianPacific IslanderTechnicians:

Native AmericanTechnicians:

ArmenianTechnicians:

MaleTechnicians:

FemaleTechnicians:

White not of Hispanic originOfficeClerical:

AfricanAmerican not of Hispanic originOfficeClerical:

HispanicOfficeClerical:

AsianPacific IslanderOfficeClerical:

Native AmericanOfficeClerical:

ArmenianOfficeClerical:

MaleOfficeClerical:

FemaleOfficeClerical:

White not of Hispanic originSkilled Craft Workers:

AfricanAmerican not of Hispanic originSkilled Craft Workers:

HispanicSkilled Craft Workers:

AsianPacific IslanderSkilled Craft Workers:

Native AmericanSkilled Craft Workers:

ArmenianSkilled Craft Workers:

MaleSkilled Craft Workers:

FemaleSkilled Craft Workers:

White not of Hispanic originOperators semi skilled:

AfricanAmerican not of Hispanic originOperators semi skilled:

HispanicOperators semi skilled:

AsianPacific IslanderOperators semi skilled:

Native AmericanOperators semi skilled:

ArmenianOperators semi skilled:

MaleOperators semi skilled:

FemaleOperators semi skilled:

White not of Hispanic originLaborers:

AfricanAmerican not of Hispanic originLaborers:

HispanicLaborers:

AsianPacific IslanderLaborers:

Native AmericanLaborers:

ArmenianLaborers:

MaleLaborers:

FemaleLaborers:

White not of Hispanic originService Workers:

AfricanAmerican not of Hispanic originService Workers:

HispanicService Workers:

AsianPacific IslanderService Workers:

Native AmericanService Workers:

ArmenianService Workers:

MaleService Workers:

FemaleService Workers:

White not of Hispanic originTOTAL:

AfricanAmerican not of Hispanic originTOTAL:

HispanicTOTAL:

AsianPacific IslanderTOTAL:

Native AmericanTOTAL:

ArmenianTOTAL:

MaleTOTAL:

FemaleTOTAL: