Attachment E CMD LBE Form 2A_Professional Services.pdf
PDF 277 KB Posted
- Attached to
- DPH | Ending HIV Epidemic Intensive Case Mgmt
- Solicitation number
- SFGOV-0000011852
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a Contract Monitoring Division (CMD) Form 2A submission document for the City and County of San Francisco used for architecture, engineering, and professional services contracts. The form serves as a mandatory attachment to proposals for contracts exceeding the delegated purchasing amount, requiring proposers, joint venture partners, subconsultants, and vendors to disclose their participation and local business enterprise (LBE) status. The related solicitation is a Request for Proposals issued by the Department of Public Health on August 10, 2026, seeking qualified firms to operate an intensive case management program for people with HIV experiencing complex behavioral health issues and unstable housing. The pre-proposal conference is scheduled for August 17, 2026, at 11:00 AM PT via Microsoft Teams, with a deadline for questions on August 24, 2026, at 5:00 PM PT. The proposal submission deadline is September 9, 2026, at 2:00 PM PT, with estimated short-listing notifications and interviews occurring in October 2026 and contract award announcement also expected in October 2026. The estimated contract start date is March 1, 2027.
The CMD Form 2A requires proposers to identify all participating firms and their respective work scopes and percentages, totaling 100 percent, while clearly designating LBE status by category (Micro, Small, or SBA-LBE). Rating bonuses are available for LBE participation, varying by contract size: contracts exceeding $400,000 but not exceeding $10,000,000 can receive up to 10 percent bonus for Micro or Small-LBE prime contractors or joint ventures, while contracts exceeding $10,000,000 but not exceeding $20,000,000 receive up to 2 percent bonus. Additional bonuses are available through the Neighborhood/Zip Code LBE Program for projects within San Francisco's jurisdictional boundaries. All firms must provide vendor numbers, Federal ID numbers, contact information, and service descriptions, with all information certified under penalty of perjury by an authorized representative.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment D 12L Compliance.docx | DOCX document | |
| Attachment F MCO Declaration Form.pdf | ||
| RFP_11852_EHE_ICM_Version_2.pdf | ||
| Attachment A Contact Information Cover Sheet.docx | DOCX document | |
| Attachment G HCAO Declaration Form.pdf | ||
| DPH___Ending_HIV_Epidemic_Intensive_Case_Mgmt.xml | XML file | |
| Attachment J HIV Referral - Acuity Scale.pdf | ||
| Attachment C Reference Form.docx | DOCX document | |
| Attachment I Cost Proposal Form_NonBHS.xlsx | XLSX spreadsheet | |
| RFP_11852_EHE_ICM_8.10.26.pdf | ||
| RFP_11852_Addendum_No_1.pdf | ||
| DPH___Ending_HIV_Epidemic_Intensive_Case_Mgmt.pdf | ||
| Attachment B Non-Collusion Affidavit Form.docx | DOCX document | |
| Attachment H First Source.docx | DOCX document | |
| RFP_Pre-Proposal_Conference_11852_EHE_ICM.pdf | ||
| Attachment M City's Contract Terms P-600 for Professional Services.pdf |
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Text version
- 11 -
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
- 12 -
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: |
| Text44: |
| Text49: |
| 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: |
| Text54: |
| 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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