Attachment D COBID Form~1.pdf
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- Solicitation number
- S-KS0060-00018127
- Issued by
- Lane County, Oregon
About this file
This document is a COBID Information Form (Attachment D) issued by the City of Springfield, Oregon, for RFP 4056 seeking Construction Manager/General Contractor (CM/GC) services for the City Hall Deferred Maintenance and Quad Redesign Project located at 225 5th Street, Springfield. The form is designed to collect information about certified firms submitting proposals and bids to the city, specifically regarding minority-owned businesses, woman-owned businesses, service-disabled veteran-owned businesses, and emerging small businesses certified by the Oregon Certification Office for Business Inclusion and Diversity (COBID). The form requests identification of the proposer's certification status, including Oregon State Certification Number and certification type (DBE, MBE, WBE, SDV, or ESB Supply), and whether the proposer foresees any subcontracting opportunities.
For proposers indicating subcontracting opportunities, the form requires submission of detailed information for each first-tier subcontractor, including contact information and certification status. The city has specified that information submitted on this form will not be considered in any scored evaluation of proposals. The document provides space for up to six subcontractors and allows for additional sheets to be attached as necessary. Completion of the subcontractor section is only required if the proposer anticipates subcontracting opportunities; otherwise, only the first page is to be submitted with the proposal.
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Text version
RFP 4056 - CMGC SERVICES FOR CITY HALL DEFERRED MAINTENANCE & QUAD REDESIGN Att D
City of Springfield COBID Form Page 1
ATTACHMENT D – COBID INFORMATION FORM
Proposer Name: Date:
Contact Name: Telephone: Email:
The City of Springfield is seeking information on Certified Firms that submit proposals and bids to the city, for the purpose of evaluating city outreach to underrepresented contractors and small businesses. The information submitted on this form will not be considered in any scored evaluation.
“Certified Firm” means a small business certified under ORS 200.055 by the Oregon Certification Office for Business Inclusion and Diversity (COBID) as minority-owned businesses, woman-owned businesses, businesses that service-disabled veterans own, and emerging small businesses.
1. Is Proposer an Oregon certified firm? Yes No
If yes, indicate all certification type(s): DBE MBE WBE SDV ESB
Supply Oregon State Certification Number: __________________________
2. Does Proposer foresee any subcontracting opportunities for this procurement? Yes No
If no, do not complete the rest of this form and submit this first page with your Proposal.
If yes, please complete the below information for each first-tier subcontractor. Attach additional sheets as necessary.
Subcontractor: Contact Name:
Telephone: Email:
Is this subcontractor an Oregon certified firm? Yes No
If yes, indicate all certification type(s): DBE MBE WBE SDV ESB
Supply Oregon State Certification Number: __________________________
Subcontractor: Contact Name:
Telephone: Email:
Is this subcontractor an Oregon certified firm? Yes No
If yes, indicate all certification type(s): DBE MBE WBE SDV ESB
Supply Oregon State Certification Number: __________________________
RFP 4056 - CMGC SERVICES FOR CITY HALL DEFERRED MAINTENANCE & QUAD REDESIGN Att D
City of Springfield COBID Form Page 2
Subcontractor: Contact Name:
Telephone: Email:
Is this subcontractor an Oregon certified firm? Yes No
Subcontractor: Contact Name:
Telephone: Email:
Is this subcontractor an Oregon certified firm? Yes No
Is this subcontractor an Oregon certified firm? Yes No
Is this subcontractor an Oregon certified firm? Yes No
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