Attachment E – VSBE Forms Page E-1 Effective Date: September 1, 2022

(Submit with Bid/Proposal) This document MUST BE included with the Bid/Proposal. If the Bidder/Offeror fails to complete and submit this form with the Bid/Proposal, the procurement officer may determine that the Bid/Proposal is not responsive/not reasonably susceptible of being selected for award.

In conjunction with the Bid/Proposal submitted in response to Solicitation No.___________________, I affirm the following:

1. VSBE Participation (PLEASE CHECK ONLY ONE)

I acknowledge and intend to meet IN FULL the overall verified VSBE participation goal of %. Therefore, I will not be seeking a waiver.

OR

After making good faith outreach efforts prior to making this submission, I conclude that I am unable to achieve the VSBE participation goal. I hereby request a waiver, in whole or in part, of the overall goal. Within 10 Business Days of receiving notice that our firm is the apparent awardee, I will submit all required waiver documentation in accordance with COMAR 21.11.14.09. If this request is for a partial waiver, I acknowledge that I must complete Attachment E-1A (VSBE Subcontractor Participation Schedule) and Attachment E-1B (Signature Page) for the portion of the VSBE goal that I intend to meet. I acknowledge that by checking this box and requesting a full waiver of the stated goal, I must complete Attachment E-1B (Signature Page) in order to be considered for award.

Additional VSBE Documentation

I understand that if I am notified that I am the apparent awardee, I must submit the following additional documentation within 10 days of receiving notice of the apparent award or from the date of conditional award (in accordance with COMAR 21.11.13.08), whichever is earlier.

(a) VSBE Waiver Request Affirmation and Good Faith Efforts Documentation to Support Waiver Request (Attachment E-1E)

(b) VSBE Outreach Efforts Compliance Statement (Attachment E-2); and

(c) Any other documentation, including waiver documentation, if applicable, required by the Procurement Officer to ascertain Bidder/Offeror responsibility in connection with the VSBE participation goal.

I understand that if I fail to return each completed document within the required time, the Procurement Officer may determine that I am not responsible and therefore not eligible for contract award. If the contract has already been awarded, the award is voidable.

Information Provided to VSBE firms

In the solicitation of subcontract quotations or offers, VSBE subcontractors were provided not less than the same information and amount of time to respond as were non-VSBE subcontractors.

Attachment E. Veteran-Owned Small Business Enterprise (VSBE) Forms

E-1

VSBE UTILIZATION AFFIDAVIT AND PRIME/SUBCONTRACTOR

PARTICIPATION SCHEDULE

Attachment E – VSBE Forms Page E-2 Effective Date: September 1, 2022

Set forth below are the (i) verified VSBEs I intend to use, (ii) the percentage of the total contract amount allocated to each VSBE Firm for this project; and (iii) a description of the work each VSBE will provide under the contract.

List information for each certified VSBE Prime Contractor or Subcontractor on this project.

Name of VSBE Prime Contractor:

Percentage of Total Contract:

VSBE Certification #:

Description of work to be performed:

Name of VSBE Subcontractor:

Please check if additional sheets are attached.

SUMMARY

Total VSBE Participation: _________%

Prime Contractor:

Project Description: Project/Contract Number:

E-1A

VSBE SUBCONTRACTOR PARTICIPATION SCHEDULE

Attachment E – VSBE Forms Page E-3 Effective Date: September 1, 2022

To complete Affidavit committing to VSBE(s) or requesting waiver, Bidder/Offeror must sign below:

I solemnly affirm under the penalties of perjury that: (i) I have reviewed the instructions for the VSBE Utilization Affidavit and VSBE Subcontractor Participation Schedule; and (ii) the information contained in the VSBE Utilization Affidavit and VSBE Subcontractor Participation Schedule are true to the best of my knowledge, information, and belief.

PLEASE PRINT OR TYPE

Company Name:

Company Address:

Name of Authorized Representative:

Title:

Signature of Authorized Representative:

Date:

E-1B

SIGNATURE PAGE

Attachment E – VSBE Forms Page E-4 Effective Date: September 1, 2022

In order to show that it has made good faith efforts to meet the established VSBE participation goal on a contract, the Bidder/Offeror must either (1) meet the VSBE Goal and document its commitments for participation of VSBE Firms, or (2) when it does not meet the VSBE Goal, document its Good Faith Efforts to meet the goal.

I. Definitions

Electronic Means – “Electronic Means” includes, for example, information provided via a website or file transfer protocol (FTP) site containing the plans, specifications, and other requirements of the contract. If an interested VSBE cannot access the information provided by electronic means, the Bidder/Offeror must make the information available in a manner that is accessible to the interested VSBE Firm.

Good Faith Efforts - The “Good Faith Efforts'' requirement means that when requesting a waiver, the Bidder/Offeror must demonstrate that it took all necessary and reasonable steps to achieve the VSBE Goal, which, by their scope, intensity, and appropriateness to the objective, could reasonably be expected to obtain sufficient VSBE participation, even if those steps were not fully successful. Whether the Bidder/Offeror that requests a waiver made adequate good faith efforts will be determined by considering the quality, quantity, and intensity of the different kinds of efforts that the Bidder/Offeror has made. The efforts employed by the Bidder/Offeror should be those that one could reasonably expect the Bidder/Offeror to take if the Bidder/Offeror were actively and aggressively trying to obtain VSBE participation sufficient to meet the VSBE contract goal and subgoals. Mere pro forma efforts are not good faith efforts to meet the VSBE contract requirements. The determination concerning the sufficiency of the Bidder/Offeror's good faith efforts is a judgment call; meeting quantitative formulas is not required.

Identified Firms – “Identified Firms” means a list of the VSBEs identified by the procuring agency during the goal setting process as available to perform the Identified Items of Work. It also may include additional VSBEs identified by the Bidder/Offeror as available to perform the Identified Items of Work.

Identified Items of Work – “Identified Items of Work” means the items identified by the procuring agency during the goal setting process and listed in the procurement as possible items of work for performance by VSBE Firms. It may also include additional portions of items of work the Bidder/Offer identified by performance by VSBE Firms to increase the likelihood that the VSBE Goal will be achieved. If the procurement does not include a list of Identified Items of Work, this term refers to all the items of work the Bidder/Offeror has identified as possible items of work for performance by VSBE Firms and should include all reasonably identifiable work opportunities.

VSBE Certification Number – The “VSBE Certification Number” is found in the eMaryland Marketplace Advantage (eMMA) vendor portal and must include an approved “VSBE Application Status” and a valid “VSBE Expiration Date.”

VSBE Firm – “VSBE Firm” refers to veteran-owned firms that are verified through the process under

21.11.14.02 and certified to participate in Maryland’s VSBE Program. Only the work of certified VSBEs can be counted toward an established VSBE contract goal.

VSBE Goal – “VSBE Goal” refers to the established VSBE contract participation goal.

E-1C

WAIVER GUIDANCE

Guidance for Documenting Good Faith Efforts to Meet VSBE Participation Goal

Attachment E – VSBE Forms Page E-5 Effective Date: September 1, 2022

II. Types of Actions Agency Will Consider The Bidder/Offeror is responsible for making relevant portions of the work available to VSBE subcontractors and suppliers and selecting those portions of the work or material needs consistent with the available VSBE subcontractors and suppliers to facilitate VSBE participation. The following is a list of types of actions the procuring agency will consider as part of the Bidder/Offeror's Good Faith Efforts when the Bidder/Offeror fails to meet the VSBE Goal. This list is not intended to be a mandatory checklist, nor is it intended to be exclusive or exhaustive. Other factors or types of efforts may be relevant in appropriate cases

A. Identify Bid/Proposal Items as Work for VSBE Firms

1. Identified Items of Work in Procurements

(a) Certain procurements will include a list of Bid/Proposal items identified during the goal setting process as possible work for performance by VSBE Firms. If the procurement provides a list of identified Items of Work, the Bidder/Offeror shall make all reasonable efforts to solicit quotes from VSBE Firms to perform that work.

(b) Bidders/Offerors may, and are encouraged to, select additional items of work to be performed by VSBE Firms to increase the likelihood that the VSBE Goal will be achieved.

2. Identified Items of Work by Bidders/Offerors

(a) Bidders/Offerors should reasonably identify sufficient items of work to be performed by VSBE Firms.

(b) Where appropriate, Bidders/Offerors should break out contract work items into economically feasible units to facilitate VSBE participation rather than perform these work items with their own forces. The ability or desire of a prime contractor to perform the work of a contract with its own organization does not relieve the Bidder/Offeror of the responsibility to make Good Faith Efforts.

B. Identify VSBE Firms to Solicit

1.VSBE Firms Identified by Bidders/Offerors

(a) When the procurement does not include a list of Identified VSBE Firms, Bidder/Offerors should reasonably identify the VSBE Firms that are available to perform the Identified Items of Work.

C. Solicit VSBEs

1. Solicit all Identified Firms for all Identified Items of Work by providing written notice. The Bidder/ Offer should:

(a) Provide the written solicitation at least 10 days prior to Bid/Proposal opening to allow sufficient time for the VSBE Firms to respond.

(b) Send the written solicitation by first-class mail or e-mail, unless the Bidder/Offeror has a valid basis for using different contact information; and

(c) Provide adequate information about the plans, specifications, anticipated time schedule for portions of the work to be performed by the VSBE Firm, and other requirements of the contract to assist VSBE Firms in responding. This information may be provided by including hard copies in the written solicitation or by Electronic Means.

2. Follow up on initial written solicitations by contacting VSBEs to determine if they are interested. The follow up contact may be made:

(a) By telephone using the contact information in the state’s vendor database, eMaryland Marketplace Advantage (eMMA), unless the Bidder/Offeror has a valid basis for using different contact information; or

Attachment E – VSBE Forms Page E-6 Effective Date: September 1, 2022

(b) In writing via a method that differs from the method used for the initial written solicitation.

3. In addition to the written solicitation set forth in C.1 and the follow up required in C.2, use all other reasonable and available means to solicit the interest of VSBE Firms certified to perform the work of the contract.

D. Negotiate with Interested VSBE Firms

Bidder/Offerors must negotiate in good faith with interested VSBE Firms.

1. Evidence of negotiation includes, without limitation, the following:

(a) the names, complete mailing addresses, and telephone numbers of VSBE Firms that were considered;

(b) a description of the information provided regarding the plans and specifications for the work selected for subcontracting and the means used to provide that information; and

(c) evidence as to why additional agreements could not be reached for VSBE Firms to perform the work.

2. The Bidder/Offeror using good business judgment would consider a number of factors in negotiating with subcontractors, including VSBE subcontractors, and would take a firm's price and capabilities as well as established VSBE contract goals into consideration.

3. The fact that there may be some additional costs involved in finding and using VSBE Firms is not in itself sufficient reason for the Bidder’s/Offeror’s failure to meet the contract VSBE goal, as long as such costs are reasonable. Factors to take into consideration when determining whether a VSBE Firm’s quote is excessive or unreasonable include, without limitation, the following:

(a) Dollar difference between the VSBE subcontractor’s quote and the average of the other subcontractors' quotes received by the Bidder/Offeror;

(b) Percentage difference between the VSBE subcontractor’s quote and the average of the other subcontractors' quotes received by the Bidder/Offeror;

(c) Percentage that the VSBE subcontractor’s quote represents of the overall contract amount;

(d) Number of VSBE firms that the Bidder/Offeror solicited for that portion of the work;

(e) Whether the work described in the VSBE and non-VSBE subcontractor quotes (or portions thereof) submitted for review is the same or comparable; and

(f) Number of quotes received by the Bidder/Offeror for that portion of the work.

4. The above factors are not intended to be mandatory, exclusive, or exhaustive, and other evidence of an excessive or unreasonable price may be relevant.

5. The Bidder/Offeror may not use its price for self-performing work as a basis for rejecting a VSBE Firm's quote as excessive or unreasonable.

6. The Bidder/Offeror should attempt to receive quotes from at least three subcontractors, including a minimum of one quote from a VSBE Firm. If needed to determine price reasonableness, the average of all subcontractors’ quotes received may be used.

7. The Bidder/Offeror shall not reject a VSBE Firm as unqualified without sound reasons based on a thorough investigation of the firm’s capabilities. For each certified VSBE that is rejected as unqualified or that placed a subcontract quotation or offer that the Bidder/Offeror concludes is not acceptable, the Bidder/Offeror must provide a written detailed statement listing the reasons for this conclusion. The Bidder/Offeror also must document the steps taken to verify the capabilities of the VSBE and non-VSBE Firms quoting similar work.

(a) The factors to take into consideration when assessing the capabilities of a VSBE Firm, include, but are not limited to the following: financial capability, physical capacity to perform, available personnel and equipment, existing workload, experience performing the type of work, conduct

Attachment E – VSBE Forms Page E-7 Effective Date: September 1, 2022 and performance in previous contracts, and ability to meet reasonable contract requirements.

(b) The VSBE Firm’s standing within its industry, membership in specific groups, organizations, or associations and political or social affiliations (for example union vs. non-union employee status) are not legitimate causes for the rejection or non-solicitation of Bids/Proposals in the efforts to meet the established VSBE Goal.

E. Assisting Interested VSBE Firms

When appropriate under the circumstances, the decision-maker will consider whether the Bidder/Offeror made reasonable efforts to assist interested VSBE Firms in obtaining:

1. The bonding, lines of credit, or insurance required by the procuring agency or the Bidder/Offeror; and

2. Necessary equipment, supplies, materials, or related assistance or services.

III. Other Considerations In making a determination of Good Faith Efforts, the decision-maker may consider engineering estimates, catalogue prices, general market availability and availability of certified VSBE Firms in the area in which the work is to be performed, other Bids/Proposals or offers and subcontract Bids/Proposals, or offers substantiating significant variances between certified VSBE and non-VSBE costs of participation and their impact on the overall cost of the contract to the State, and any other relevant factors.

The decision-maker may take into account whether the Bidder/Offeror decided to self-perform subcontract work with its own forces, especially where the self-performed work is Identified Items of Work in the procurement. The decision-maker also may take into account the performance of other Bidders/Offerors in meeting the VSBE contract goal. For example, when the apparent successful Bidder/Offeror fails to meet the established VSBE contract goal, but other Offers meet it, this reasonably raises the question of whether, with additional reasonable efforts, the apparent successful Bidder/Offeror could have met the goal. If the apparent successful Bidder/Offeror fails to meet the goal but meets or exceeds the average VSBE participation obtained by other Bidders/Offerors, this, when viewed in conjunction with other factors, could be evidence of the apparent successful Bidder/Offeror having made Good Faith Efforts.

IV. Documenting Good Faith Efforts At a minimum, the Bidder/Offeror seeking a waiver of the established VSBE Goal, or a portion thereof, must provide written documentation of its Good Faith Efforts, in accordance with COMAR 21.11.14.09, within 10 business days after receiving notice that it is the apparent awardee. The written documentation shall include the following:

A. Items of Work (Complete VSBE Waiver Request Affirmation and Good Faith Efforts Documentation to Support Waiver Request Attachment E-1E, Part 1)

1. A detailed statement of the efforts made to select portions of the work proposed to be performed by certified VSBE Firms in order to increase the likelihood of achieving the stated VSBE Goal(s).

B. Outreach/Solicitation/Negotiation

1. The record of the Bidder’s/Offeror’s compliance with the outreach efforts prescribed by COMAR 21.11.14.07C(1). (Complete Outreach Efforts Compliance Statement E-2).

2. A detailed statement of the efforts made to contact and negotiate with VSBE Firms including:

(a) the names, addresses, and telephone numbers of the VSBE Firms who were contacted, with the dates and manner of contacts (letter, fax, e-mail, telephone, etc.) (Complete VSBE Waiver Request Affirmation and Good Faith Efforts Documentation to Support Waiver Request Attachment E-1E and submit letters, fax cover sheets, e-mails, etc. documenting solicitations);

and, Attachment E – VSBE Forms Page E-8 Effective Date: September 1, 2022

(b) a description of the information provided to VSBE Firms regarding the plans, specifications, and anticipated time schedule for portions of the work to be performed and the means used to provide that information.

C. Rejected VSBE Firms (Complete Good Faith Efforts Documentation)

1. For each VSBE Firm that the Bidder/Offeror concludes is not acceptable or qualified, a detailed statement of the reasons for the Bidder’s/Offeror’s conclusion, including the steps taken to verify the capabilities of the VSBE and Non-VSBE Firms quoting similar work.

2. For each certified VSBE Firm that the Bidder/Offeror concludes has provided an excessive or unreasonable price, a detailed statement of the reasons for the Bidder’s/Offeror’s conclusion, including the quotes received from all VSBE and non-VSBE firms proposing on the same or comparable work. (Include copies of all quotes received.)

3. A list of VSBE Firms contacted but found to be unavailable. This list should be accompanied by a VSBE Unavailability Certificate (E-1D) signed by the VSBE contractor or a statement from the Bidder/Offeror that the VSBE contractor refused to sign the VSBE Unavailability Certificate.

D. Other Documentation

1. Submit any other documentation requested by the Procurement Officer to ascertain the Bidder’s/Offeror's Good Faith Efforts.

2. Submit any other documentation the Bidder/Offeror believes will help the Procurement Officer ascertain its Good Faith Efforts.

Attachment E – VSBE Forms Page E-9 Effective Date: September 1, 2022

1. It is hereby certified that the firm of (Name of VSBE Firm) located at

(Street)

(City) (State) (Zip) was offered an opportunity to bid on Solicitation No._________________________________________ in County, by (Name of Prime Contractor’s Firm)

2. is either unavailable for the work/service or

(Name of VSBE Firm) unable to prepare a Bid/Proposal for this project for the following reason(s):

Signature of firm’s VSBE Representative Title Date

VSBE Certification # Phone #

3. To be completed by the Prime Contractor if Section 2 of this form is not completed by the VSBE Firm.

To the best of my knowledge and belief, said VSBE Firm is either unavailable for the work/service for this project, is unable to prepare a Bid/Proposal, or did not respond to a request for a price Bid/Proposal and has not completed the above portion of this submittal.

Signature of Prime Contractor Title Date

E-1D

VSBE SUBCONTRACTOR UNAVAILABILITY CERTIFICATE

Attachment E – VSBE Forms Page E-10 Effective Date: September 1, 2022

PAGE _______ OF _______

Prime Contractor: Project Description: Project/Contract

Bidder/Offeror Company Name, Address, Phone, and Email

Solicitation #:

Parts 1, 2, and 3 must be included with this affirmation along with all documents supporting the waiver request.

I affirm that I have reviewed Waiver Guidance (E-1C).

I further affirm, under penalties of perjury, that the contents of Good Faith Efforts Documentation to Support Waiver Request (E-1E, Part 1, 2 & 3) are true to the best of my knowledge, information, and belief.

Company Address:

Name of Authorized Representative:

Signature of Authorized Representative:

E-1E

VSBE WAIVER REQUEST AFFIRMATION AND GOOD FAITH EFFORTS

DOCUMENTATION TO SUPPORT WAIVER REQUEST

Attachment E – VSBE Forms Page E-11 Effective Date: September 1, 2022

Good Faith Efforts Documentation to Support Waiver Request Part 1 – Identified Items of Work Bidder/Offeror Made Available to VSBE Firms

PAGE_______ OF ________

Address, Phone, and Email

Solicitation #:

Identify those items of work that the Bidder/Offeror made available to VSBE Firms. This includes, where appropriate, those items the Bidder/Offeror identified and determined to subdivide into economically feasible units to facilitate the VSBE participation. For each item listed, show the anticipated percentage of the total contract amount. It is the Bidder/Offeror’s responsibility to demonstrate that sufficient work to meet the goal was made available to VSBE Firms, and the total percentage of the items of work identified for VSBE participation equals or exceeds the percentage VSBE goal set for the procurement. Note: If the procurement includes a list of Bid/Proposal items identified during the goal setting process as possible items of work for performance by VSBE Firms, the Bidder/Offeror should make all those items of work available to VSBE Firms or explain why that item was not made available. If the Bidder/Offeror selects additional items of work to make available to VSBE Firms, those additional items should also be included below.

Identified Items of Work Was this work listed in the procurement?

Does Bidder/Offer or normally self- perform this work?

Was this work made available to VSBE Firms?

If no, explain why not.

□ Yes □ No □ Yes □ No □ Yes □ No

Attachment E – VSBE Forms Page E-12 Effective Date: September 1, 2022

Part 2 – Identified VSBE Firms and Record of Solicitations

Solicitation #:

Identify the VSBE Firms solicited to provide quotes for the Identified Items of Work made available for VSBE participation. Include the name of the VSBE Firm solicited, items of work for which quotes were solicited, date and manner of initial and follow-up solicitations, whether the VSBE provided a quote, and whether the VSBE is being used to meet the VSBE participation goal. VSBE Firms used to meet the participation goal must be included on the VSBE Participation Schedule. Note: If the procurement includes a list of the VSBE Firms identified during the goal setting process as potentially available to perform the items of work, the Bidder/Offeror should solicit all of those VSBE Firms or explain why a specific VSBE was not solicited. If the Bidder/Offeror identifies additional VSBE Firms who may be available to perform Identified Items of Work, those additional VSBE Firms should also be included below. Copies of all written solicitations and documentation of follow-up calls to VSBE Firms must be attached to this form. This list should be accompanied by a VSBE Subcontractor Unavailability Certificate (E-1D).

Name of VSBE Firm & VSBE Certification #

Describe Item of Work Solicited

Initial Solicitation

Date & Method

Follow-up Solicitation

Date & Method

Details for Follow-up

Calls Quote Rec’d

Quote Used

Reason Quote

Rejected Firm Name:

VSBE Cert. #

□ Mail

□ Facsimile

□ Email

□ Phone

Time of Call:

Spoke with:

□ Yes

□ No

□ Used Other

VSBE

□ Used non-

VSBE

□ Self-performing

□ Left Message

Firm Name:

VSBE Cert. #

□ Phone

Time of Call:

Spoke with:

□ Used Other

VSBE

□ Used non-

VSBE

□ Self-performing

□ Left Message

Attachment E – VSBE Forms Page E-13 Effective Date: September 1, 2022

Part 3 – Additional Information Regarding Rejected VSBE Quotes

Prime Contractor: Project Description: Project/Contract Number:

Solicitation #

This form must be completed if Part 1 indicates that a VSBE quote was rejected because the Bidder/Offeror is using a non-VSBE or is self-performing the Identified Items of Work. Provide the Identified Items Work, indicate whether the work will be self-performed or performed by a non-VSBE, and if applicable, state the name of the non-VSBE. Also include the names of all VSBE and non-VSBE Firms that provided a quote and the amount of each quote.

Describe Identified Items of Work Not Being Performed by VSBE

(IMPORTANT: Include spec/section number from Bid/Proposal)

Self-performing or using non-VSBE

Amount of non-

VSBE

Quote

Name of Other Firms who Provided Quotes & Whether VSBE or non-VSBE

Amount Quoted

Indicate Reason Why VSBE Quote Rejected & Briefly Explain

□ Self-performing

□ Using non-VSBE

Name of firm:

□ Price

□ Capabilities

□ Other

□ VSBE

□ non-VSBE

□ Other □ VSBE

□ Other □ VSBE

□ Other

□ VSBE

Attachment E – VSBE Forms Page E-14 Effective Date: September 1, 2022

Complete and submit this form within 10 Business Days of notification of apparent award or actual award, whichever is earlier.

In conjunction with the Bid/Proposal submitted in response to Solicitation No. __________________, I state the following:

1. Bidder/Offeror identified subcontracting opportunities in these specific work categories.

2. Attached to this form are copies of written solicitations (with Bid/Proposal instructions) used to solicit certified VSBE firms for these subcontract opportunities.

3. Please Check One:

□ This project does not involve bonding requirements.

□ Bidder/Offeror assisted certified VSBE firms to fulfill or seek waiver of bonding requirements. (DESCRIBE EFFORTS):

Mailing Address:

Name of Authorize Representative:

Signature of Authorized Representative

E-2

VSBE OUTREACH EFFORTS COMPLIANCE STATEMENT

Attachment E – VSBE Forms Page E-15 Effective Date: September 1, 2022

Complete and submit one form for each verified VSBE listed on VSBE Utilization Affidavit and Prime/Subcontractor Participation Schedule (E-1) within 10 business days of notification of apparent award.

___________________________________________(Prime Contractor) has entered into a contract

___________________________________________ (Subcontractor) to provide services in connection with the Solicitation described below.

Prime Contractor (Firm Name, Mailing Address, Phone):

Project Description:

Solicitation Number: Total Contract Amount: $

Name of VSBE Firm:

Address:

FEIN:

Work to be Performed:

Percentage of Total Contract Amount to be Performed by this VSBE:

Total VSBE Subcontract Amount: $

The undersigned Prime Contractor and VSBE Subcontractor hereby certify and agree that they have fully complied with the State Veteran-Owned Small Business Enterprise Program law, State Finance and Procurement Article, Title 14, Subtitle 6, Annotated Code of Maryland.

Prime Contractor Subcontractor

Printed Name Printed Name

Printed Title Printed Title

Signature of Authorized Representative Signature of Authorized Representative

Date Date

E-3

VSBE SUBCONTRACTOR PARTICIPATION STATEMENT

Attachment E – VSBE Forms Page E-16 Effective Date: September 1, 2022

Report #: Solicitation #:

Reporting Period (Month/Year): Contracting Unit:

Note to Report Preparer:

Report is due by the 10th of the month following the month the services were provided. Please number reports in sequence.

Contract Amount:

VSBE Subcontract Amount:

Project Start Date:

Project End Date:

Services Provided:

Prime Contractor: Contact Person:

Address:

City: State: ZIP:

Phone: E-mail:

VSBE Subcontractor: Contact Person:

Phone: E-mail:

Subcontractor Services Provided:

List all payments made to VSBE subcontractor named above during this reporting period:

List dates and amounts of any outstanding invoices:

Invoice # Amount Invoice # Amount 1.

1.

2.

2.

3.

3.

4.

4.

Total Dollars Paid: $

Total Dollars Unpaid: $

• If more than one VSBE Subcontractor is used for this contract, you must submit separate forms for each VSBE Subcontractor.

• Return an electronic signed copy of this/each form to the following e-mail addresses:

Contract Monitor/Contracting Unit VSBE Liaison

E-mail E-mail

Phone Number Phone Number

Contractor Signature (Required) Date

E-4

VSBE PARTICIPATION

VSBE Prime Contractor Paid/Unpaid Invoice Report

Attachment E – VSBE Forms Page E-17 Effective Date: September 1, 2022

Report #: Solicitation #:

Reporting Period (Month/Year): Contracting Unit:

Note to Report Preparer:

Report is due by the 10th of the month following the month the services were performed. Please number reports in sequence.

VSBE Subcontract Amt:

Project Start Date:

Project End Date:

Services Provided:

VSBE Subcontractor Name:

Contact Person:

Address:

City: State: ZIP:

Phone: E-mail:

Subcontractor Services Provided:

List all payments received from Prime Contractor during reporting period indicated above.

List dates and amounts of any unpaid invoices over 30 days old.

Invoice Amount Date Invoice Amount Date

1. 1.

2. 2.

3. 3.

4. 4.

Total Dollars Paid: $

Total Dollars Unpaid: $

Prime Contractor:

Contract Person:

• Return an electronic signed copy of this/each form to the following e-mail addresses:

Contract Monitor/Contracting Unit VSBE Liaison

E-mail E-mail

Phone Number Phone Number

Subcontractor Signature (Required) Date

E-5

VSBE PARTICIPATION

VSBE Subcontractor Paid/Unpaid Invoice Report