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PDF 185 KB Posted Apr 18, 2025

Attached to: Nankin Mills Campus Improvements
Solicitation number: 37-25-049
Issued by: Wayne County, Michigan

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Written by GovTribe AI · Apr 19, 2025

The document is a Disadvantaged Business Enterprise (DBE) Participation Form and Debarment Form for Wayne County, Michigan, specifically Appendix G and G.2 of a bid package. The form is designed to encourage participation by Disadvantaged Business Enterprises (DBEs), Women-Owned Business Enterprises (WBEs), and Minority Business Enterprises (MBEs) in county contracts. Bidders are required to list the percentage of DBE participation proposed, provide detailed descriptions of each DBE participant's responsibilities, and confirm their certification status with the Michigan United Certification Program (MUCP).

The form requires bidders to disclose support provided to DBE partners, including financial, technical, management, and training assistance, and to submit documentation of the legal relationship between the primary bidder and DBE participants. Additionally, the Debarment Form mandates that participants certify they are not currently debarred, suspended, or proposed for debarment by federal agencies, have not had public transactions terminated for cause, and are not currently indicted or criminally charged for specific offenses such as fraud, antitrust violations, or embezzlement. False statements on this form can result in proposal rejection and potential legal consequences, including fines up to $10,000 or imprisonment for up to five years.

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Other files

File	Type	Posted
Appendix B - Sample Agreement.pdf	PDF	Apr 18, 2025
Appendix D - Example Performance and Payment Bonds.pdf	PDF	Apr 18, 2025
Appendix E - Nankin Mills Design Intent Package.pdf	PDF	Apr 18, 2025
Appendix F.2 Construction Plans and Drawings.pdf	PDF	Apr 18, 2025
First Tier Subcontractor_designation_form-final 8-2023.pdf	PDF	Apr 18, 2025
Ethics Form rev 8-16-21.pdf	PDF	Apr 18, 2025
Appendix C - Consortium Agreement.pdf	PDF	Apr 18, 2025
IFB #37-25-049 Nankin Mills Improvements.pdf	PDF	Apr 18, 2025
Appendix A - Price Sheet.xlsx	XLSX spreadsheet	Apr 18, 2025
Appendix F.1 Supplemental Requirements and Specifications.pdf	PDF	Apr 18, 2025
W-9 Form v10-18.pdf	PDF	Apr 18, 2025

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APPENDIX G

DBE Participation Form

Debarment Form

DISADVANTAGED BUSINESS ENTERPRISE (DBE)

PARTICIPATION FORM

Failure to complete this form may result in your bid or proposal being deemed nonresponsive and rejected without any further evaluation.

(Make additional copies if more than two DBE firms are participating.)

1. The County and funding agencies strongly encourage participation by Disadvantaged Business Enterprises (DBE) for this contract (DBEs, WBEs and MBEs)

2. List the % level of DBE Participation proposed: ___% WBE ___% MBE ___% DBE Total DBE=___%

3. Describe, in detail, the responsibilities of each DBE participant (attach additional sheets, if necessary) (To be counted towards the DBE goal, a firm must either be certified or have applied for certification by the due date on the cover of this document.)

DBE Name: % of Total Contract:_____________

Address: ________________________________________________________________________

Contact Name: Phone #: _____________________

Detailed Description of Responsibilities: ________________________________________________

Is the business certified as an DBE by an agency participating in the Michigan United Certification Program (MUCP) _____ YES _____ NO If no, have they applied for certification with an agency participating in the MUCP _____ YES _____ NO. Proof of certification or documentation from a certifying agency confirming receipt of DBE certification application must be submitted with this form.

Is the Business an MBE ___ YES ___ NO? If yes, who certified the Business? ___ Wayne County ___

MDOT

Is the Business a WBE ___ YES ___ NO? If yes, who certified the Business? ___ Wayne County ___

MDOT

Include the following (if applicable):

• The support (financial, technical, management, training, etc.) provided by the Proposer to each DBE partner.

• A copy of the documents that contain the proposed legal relationship between Proposer and each DBE participant (if applicable).

• Provide a resume for the principal(s) of the firms identified above.

DBE Name: % of Total Contract: _________________

Address: _____________________________________________________________________________

Contact Name: Phone #: __________________________

Detailed Description of Responsibilities:_____________________________________________________

Is the Business an MBE ___ YES ___ NO? If yes, who certified the Business? ___ Wayne County ___ MDOT Is the Business a WBE ___ YES ___ NO? If yes, who certified the Business? ___ Wayne County ___ MDOT

Include the following (if applicable):

• The support (financial, technical, management, training, etc.) provided by the Bidder to each DBE partner.

• A copy of the documents that contain the proposed legal relationship between Bidder and each DBE participant (if applicable).

• Provide a resume for the principal(s) of the firms identified above.

For assistance, or for more information on the DBE program or the MUCP, contact Human Relations at 313-224-5021.

Appendix G.1

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APPENDIX G.2

APPENDIX F

DBE Participation Form

Debarment Form

File details come from the government source that posted it. Updated Apr 19, 2025.