Attachment E CMD LBE Form 2A_1.pdf

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Attached to
DPH | 503A Sterile Compounding Pharmacy Services
Solicitation number
SFGOV-0000011956
Issued by
California

About this file

This is a Contract Monitoring Division (CMD) Attachment 2 form for Architecture, Engineering, and Professional Services contracts issued by the City and County of San Francisco. The form serves as the CMD Contract Participation Form required for submission with proposals to the Department of Public Health (DPH) for 503A Sterile Compounding Pharmacy Services at Zuckerberg San Francisco General Hospital. The RFP was published on September 8, 2026, with a pre-proposal conference scheduled for September 21, 2026, at 1:00 PM PST. The deadline for submitting questions is September 28, 2026, at 5:00 PM PST, with a question and answer addendum posting on October 5, 2026. Proposals are due on October 12, 2026, at 2:00 PM PST. Short-listing notifications for interviews are estimated for November 9, 2026, with demonstrations scheduled for November 12-20, 2026. The contract award is estimated to be announced on December 2, 2026, with a Health Commission presentation potentially occurring in February 2027 and an estimated service start date of March 1, 2027.

The form requires proposers, joint venture partners, subconsultants, vendors, and lower sub-tier firms to disclose their participation and LBE (Local Business Enterprise) status. Proposers must meet specified LBE sub-participation requirements, which vary by contract size and category (Micro, Small, or SBA-LBE). Rating bonuses are available based on contract estimated cost thresholds: up to 10% for Micro or Small-LBE contracts valued between $400,000 and $10,000,000; up to 2% for contracts exceeding $10,000,000 but not exceeding $20,000,000; and additional bonuses for Neighborhood/Zip Code LBE programs and Mentor-Protege programs as applicable. The form requires signature declarations under penalty of perjury and must be completed in full with vendor numbers, federal identification numbers, and service descriptions for all participating firms.

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Text version

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11/01/2025

CITY AND COUNTY OF SAN FRANCISCO

CONTRACT MONITORING DIVISION

CHAPTER 14B

CMD ATTACHMENT 2

Architecture, Engineering, and Professional Services

FORM 2A: CMD CONTRACT PARTICIPATION FORM

Section 1: This form must be submitted with the proposal or the proposal may be deemed non-responsive and rejected. Proposer, each Joint Venture partner, Subconsultants, Vendors, and lower sub tiers must be listed on this form. The RFP/RFQ will state which LBE size category (e.g., Micro, Small, and/or SBA-LBE) can be used to meet the LBE sub participation requirement(s). All LBE Proposers/JVs with LBE participation must meet the LBE sub participation requirement(s). Any LBE Proposer/JV with LBE participation may not count its participation towards meeting the LBE sub participation requirement(s). Be sure to check the appropriate box for Rating Bonus under Section 2. If more space is needed for Section 1, attach additional copies of this form.

*Type: Identify if Prime (P), JV partner (J), Subconsultant (S), or Vendor (V)

TY

PE

Firm

Portion of Work

(Describe Scope(s) of

Work)

% of Work

Indicate LBE or Non-LBE. If LBE, Micro, Small, or

SBA.

% of LBE Subwork (Carry-Over from % OF

Work Column)

Micro Small SBA

Total % of Work: 100% Total LBE Sub Participation: % % %

I declare, under penalty of perjury under the laws of the State of California, that I am utilizing the above Consultants for the portions of work and amounts as reflected in the proposal for this Contract.

Owner/Authorized Representative (Signature): _____________________ Date: _________________________

Print Name and Title: _____________________________________________________________________________

** See CMD website: http://www.sfgov.org/cmd for each firm’s status

Contract No.:

Contract Title: LBE SUBPARTICIPATION REQUIREMENT(S)

Firm: Micro and Small-LBE Sub Requirement – ___%

Contact Person: Micro, Small, SBA-LBE Sub Requirement – ___%

Address: Micro-LBE Sub Requirement - ___%

City/ZIP: Small-LBE Sub Requirement – ___%

Phone, Email: SBA-LBE Sub Requirement – ___% http://www.sfgov.org/cmd

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Section 2. Rating Bonus

Check applicable boxes.

A. NO Rating Bonus Requested 0%

B. Contracts with an Estimated Cost in Excess of $400,000 and Less Than or Equal to $10,000,000. See instructions in Sections 2.01 and 2.02.

Micro or Small-LBE 10%

Joint Venture 7.5%

Joint Venture 5%

Joint Venture (Micro or Small-LBEs only) 10%

SBA-LBE 5%

C. Contracts with an Estimated Cost in Excess of the Delegated Purchasing Amount ($20,000 as of July 1, 2024) and Less Than or Equal to $10,000,000. The below rating bonuses DO NOT apply to Chapter 21 contracts and only apply to Chapter 6 contracts, including Chapter 6.40. See instructions in Section

2.01 for details. This Neighborhood/Zip Code LBE Program shall apply to projects located within the jurisdictional boundary of San Francisco. The program shall not apply to Job Order Contracts (JOC), As- Needed contracts, or other contracts where no specific project location is specified at the time of proposal. The RFP/RFQ will clearly state whether the Pilot Neighborhood/Zip Code LBE Program is applicable to the specific project. A Proposer may receive up to a maximum rating bonus of 13% depending on the particular application.

Prime Neighborhood/Zip Code LBE rating bonus:

Prime Neighborhood LBE (or a JV where the Neighborhood LBE JV partner(s)’ participation is at least 40%) 1%

OR

Prime Zip Code LBE (or a JV where the Prime Zip Code LBE JV partner(s)’ participation is at least 40%) 1.5%

Subconsulting Neighborhood/Zip Code LBE rating bonus:

Sub Neighborhood LBE 0.5%

OR

Sub Zip Code LBE 1.5%

D. Contracts in Excess of $10,000,000 and Less Than or Equal to $20,000,000. See instructions in Section 2.01.

Micro, Small, or SBA-LBE 2%

E. Mentor-Protégé Program Bid Discount/Rating Bonus. The Mentor Protégé rating bonus is not applicable to professional services contracts. However, for this CMD Attachment 2, the Mentor Protégé rating bonus/bid discount is applicable for Design-Build and/or CM/GC projects only. See instructions in Section 2.01.

Mentors of the Mentor-Protégé Program 1%

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Section 3. Proposer, Joint Venture Partners, Subconsultant, and Vendor Information

Provide information for each firm listed in Section 1 of this form. Firms which have previously worked on City contracts may already have a vendor number. Vendor numbers of LBE firms are located on the CMD LBE website at http://www.sfgov.org/cmd. Use additional sheets if necessary.

FIRM NAME: VENDOR #:

ADDRESS: FEDERAL ID #:

CITY, ST, ZIP: PHONE: EMAIL:

SERVICE:

CITY, ST, ZIP: PHONE: EMAIL:

SERVICE:

http://www.sfgov.org/cmd

Contract No:
Contract Title:
Firm:
Contact Person:
Address:
CityZIP:
Phone Email:
Micro and SmallLBE Sub Requirement: Off
Text30:
Micro Small SBALBE Sub Requirement: Off
Text31:
MicroLBE Sub Requirement: Off
Text32:
SmallLBE Sub Requirement: Off
Text33:
SBALBE Sub Requirement: Off
Text34:
Text201:
FirmRow1:
Portion of Work Describe Scopes of WorkRow1:
Text205:
Indicate LBE or NonLBE If LBE identify MBE WBE or OBE AND Micro Small or SBA:
Text35:
Text39:
Text45:
Text202:
FirmRow2:
Portion of Work Describe Scopes of WorkRow2:
Text206:
Indicate LBE or NonLBE If LBE identify MBE WBE or OBE AND Micro Small or SBA_2:
Text36:
Text40:
Text46:
Text203:
FirmRow3:
Portion of Work Describe Scopes of WorkRow3:
Text207:
Indicate LBE or NonLBE If LBE identify MBE WBE or OBE AND Micro Small or SBA_3:
Text37:
Text41:
Text47:
Text204:
FirmRow4:
Portion of Work Describe Scopes of WorkRow4:
Text208:
Indicate LBE or NonLBE If LBE identify MBE WBE or OBE AND Micro Small or SBA_4:
Text38:
Text43:
Text48:
Text42:
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Text1:
Date:
Print Name and Title:
NO Rating Bonus Requested 0: Off
Micro or SmallLBE 10: Off
Joint Venture 75: Off
Joint Venture 5: Off
Joint Venture Micro or SmallLBEs only 10: Off
SBALBE 5: Off
Prime Neighborhood LBE or a JV where the Neighborhood LBE JV partners participation is at: Off
Prime Zip Code LBE or a JV where the Prime Zip Code LBE JV partners participation is at least: Off
Sub Neighborhood LBE 05: Off
Sub Zip Code LBE 15: Off
Micro Small or SBALBE 2: Off
Mentors of the MentorProtégé Program 1: Off
FIRM NAME:
Text50:
ADDRESS:
Text51:
Text53:
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Text52:
Text55:
FIRM NAME_2:
Text56:
ADDRESS_2:
Text57:
Text71:
Text76:
Text58:
Text81:
FIRM NAME_3:
Text59:
ADDRESS_3:
Text60:
Text72:
Text77:
Text61:
Text82:
FIRM NAME_4:
Text62:
ADDRESS_4:
Text63:
Text73:
Text78:
Text64:
Text83:
FIRM NAME_5:
Text65:
ADDRESS_5:
Text66:
Text74:
Text79:
Text67:
Text84:
FIRM NAME_6:
Text68:
ADDRESS_6:
Text69:
Text75:
Text80:
Text70:
Text85:

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