EO3-200_-_Small_Business_Utilization_Commitment.pdf

Airport Concession Disadvantaged Business Enterprise - Neutral (ACDBE- N) Program

04_26-IFR AVN RCS FORM EO3 – 200

FORM EO3 - 200 – SMALL BUSINESS UTILIZATION COMMITMENT

(Due with initial submittal)

Solicitation Number: Solicitation Title:

On behalf of the Respondent, I certify that the following information is true and correct:

1. The firms indicated as “Selected” in Form EO2 - 200 - Small Business Outreach Efforts, will participate in this contract.

2. The Successful Respondent will comply with the Post-Award compliance requirements as stated in the ACDBE- Neutral Lease Clause.

3. Successful Respondent understands and agrees that any and all changes or substitutions to subleases or subcontracts with Small Businesses must be authorized by the City, including EOD, prior to implementation; and

4. The following statement is true and correct:

The proposed total participation (% or $s) on this lease will be:

Name of Selected Small Business as identified on FORM EO2

Small Business Utilization Commitment

Submit Values as either % or $

Small Business Verification

THIS SECTION TO BE COMPLETED BY

CITY OF PHOENIX ONLY

___% | $____________ Is the business a verified small business

YES NO

___% | $____________ Is the business a verified small business

YES NO

___% | $____________ Is the business a verified small business

YES NO

___% | $____________ Is the business a verified small business

YES NO

___% | $____________ Is the business a verified small business

YES NO

Respondents should attach an additional page if more “Selected” firms are identified.

Company Name:

Company Mailing Address:

Representative Name:

Title:

Email Address:

Phone Number:

Signature: Date:

ATTACHMENT I