Attachment_4_-_DVBE_Participation_Incentive_Form.pdf
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- Solicitation number
- 0000034798
- Issued by
- Sacramento County, Sacramento City, West Sacramento City, California
About this file
The document is a DVBE (Disabled Veteran Business Enterprise) Participation Incentive Form for RFP-24-004, which allows bidders to indicate their commitment to involving disabled veteran-owned businesses in the contract opportunity. The form provides two participation methods: Method A for California Certified DVBE Bidders who commit to performing a percentage of the contract with their own resources or DVBE subcontractors, and Method B for Non-DVBE Bidders who commit to using California Certified DVBEs for a specified amount.
The form includes an incentive structure where bidders can receive a bid incentive percentage based on their confirmed DVBE participation level, ranging from 1% (for 1% to 1.99% DVBE participation) up to 5% (for 5% DVBE participation). Bidders must checkmark their chosen participation method and percentage goal, with the option to opt out of the DVBE Participation Incentive by marking "No" on the form. The document requires the authorized representative's printed name, signature, and date to complete the form.
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Text version
ATTACHMENT __________: DVBE PARTICIPATION INCENTIVE FORM
Who completes this form? Bidder(s) who want to participate in the DVBE Participation Incentive only. If you do not want to participate, checkmark “No” on question #2 and then sign and date below.
RFP No.: ______________________
1. Bidder/Company Name
2.
Are you participating in the DVBE Participation Incentive per RFP?
________ Yes _______ No
If no, skip the following questions and sign and date below.
3.
Indicate which of the two methods? Checkmark one only.
_______ Method A: California Certified DVBE Bidder.
Commit to perform the participation goal percentage of the contract bid amount with its own resources or in combination of other California Certified DVBE(s) as subcontractors.
_______ Method B: Non-DVBE Bidder Commit to use California Certified DVBEs for the amount stated in the bid document.
4. DVBE Bid Incentive.
Checkmark your percentage participation goal.
Checkmark One only
Confirmed DVBE Participation
DVBE Incentive
5% 5%
4% to 4.99% inclusive
4%
3% to 3.99% inclusive
3%
2% to 2.99% inclusive
2%
1% to 1.99% inclusive
1%
Print Name of Authorized Representative
Signature of Authorized Representative Date
| DVBE PARTICIPATION INCENTIVE FORM: 4 |
| RFP No: RFP-24-004 |
| BidderCompany Name: |
| Checkmark One onlyRow1: |
| Checkmark One onlyRow2: |
| Checkmark One onlyRow3: |
| Checkmark One onlyRow4: |
| Checkmark One onlyRow5: |
| Print Name of Authorized Representative: |
| Date: |
| Check Box15: Off |
| Check Box16: Off |
| Check Box17: Off |
| Check Box18: Off |
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