City_of_Tampa_Subcontractors_Solicited.PDF

City of Tampa – DMI -Schedule of All Sub-(Contractors/Consultants/Suppliers) Solicited

Contract No.: __________ Contract Name: _________________________________________________________ Contractor Name: _________________________________ Address ______________________________________ Federal ID __________________ Phone ____________ Fax ____________ Email __________________________ [ ] No Firms were contacted/solicited for this contract.

[ ] No Firms were contacted because _________________________________________________________________________________ [ ] See attached documents with supplemental information.

NIGP Code General Categories: Buildings = 909, General = 912, Heavy = 913, Trades = 914, Architects = 906, Engineers & Surveyors = 925, Supplier = 912-77 This DMI Schedule Must Be Submitted with the Bid or Proposal (Do Not Modify This Form)

S = SLBE

W=WMBE Company Name

Address Phone & Fax

Type of Ownership (F=Female M=Male) BF BM = African Am.

HF HM = Hispanic Am.

AF AM = Asian Am.

NF NM = Native Am.

CF CM = Caucasian

Trade or Services

NIGP Code

(listed above)

Contact Method L=Letter F=Fax

E=Email P=Phone

Quote or

Resp.

Rec’d Y/N Federal ID

It is hereby certified that the information provided is an accurate and true account of contacts and solicitations for sub -contracting opportunities on this contract. This form must be completed with the bid or proposal. Modifying or failing to sign DMI forms may result in Non-Compliance

Signed ________________________________ Name/Title _____________________________ Date: __________

MBD 10 rev. 03/08/12 Pg __ of __ Note: Detail Instructions for completing on back side

Instructions for completing The Sub-(Contractors/Consultants/ Suppliers) Solicited Form (Form MBD-10)

This form must be submitted with all bids or proposals

. All subcontractors (regardless of ownership or size) solicited and subcontractors from whom unsolicited quotations were received must be included on this form.

The instructions that directly follow are for the form heading information pertaining to the project and prime.

Contract No. This is the number assigned by the City of Tampa for the bid or proposal Contract Name. This is the name of the contract assigned by the City of Tampa for the bid or proposal.

Contractor Name. The name of your business.

Address. The physical address of your business.

Federal ID. FIN. A number assigned to your business for tax reporting purposes.

Phone. Telephone number to contact business.

Fax. Fax number for business.

Email. Provide email address for electronic correspondence.

No Firms were contacted/solicited for this contract. Checking the box indicates that a pre-determined Subcontract Goal was not set by the City and, as a result; your business will not use subcontractors but will self-perform all work. If during the administration of the contract you use subcontractors, the “Sub- (Contractors/Consultants/Suppliers) Payments” form must be submitted with your invoices. Note: Certified SLBE or WMBE firms bidding as Primes are not exempt No Firms were contracted because. Provide brief explanation why no subcontractors were used.

from outreach and solicitation of subcontractors.

See attached documents. Check if you have provided any additional documentation relating to the form.

The following instructions are for information of any and all subcontractors solicited.

“S” = SLBE, “W” = WMBE. Enter “S” for firms Certified by the City as Small Local Business Enterprises and/or “W” for firms Certified by the City as Women/Minority Business Enterprise.

Federal ID. FIN. A number assigned to a business for tax reporting purposes. This information is critical in proper identification of the subcontractor.

Company Name, Address, Phone & Fax. Provide company information for verification of payments.

Type of Ownership. Indicate the Ethnicity and Gender of the owner of the subcontracting business.

Trade, Services, or Materials Indicate the trade, service, or material provided by the subcontractor. NIGP codes are listed at top section of document.

Contract Method L=letter, F=fax, E=Email, P=Phone. Indicate with letter the method of soliciting for bid.

Quote or Resp. (response) Rec’d (received) Y/N. Indicate “Y” Yes if you received a quotation or if you received a response to your solicitation. Indicate “N” No if you received no response to your solicitation from the subcontractor.

If any additional information is required or you have any questions, you may call the Minority Business Development Office at (813) 274-5522.