EXHIBIT 4 - BIDDERS LIST FORM.pdf
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- Attached to
- UPS Battery Replacement Location 64
- Solicitation number
- PS132603(2)
- Issued by
- California
About this file
This is a Bidders List Form (PRO FORM 132) required by the Los Angeles County Metropolitan Transportation Authority (LACMTA) in compliance with 49 CFR 26.11(c) for Department of Transportation (DOT)-assisted projects. The form is used to compile and maintain a comprehensive bidders list that documents all bidders, proposers, quoters, subcontractors, manufacturers, and suppliers of materials and services who submitted bids during the advertising period of a specific acquisition, regardless of bid success. The form captures information for multiple bidders and is designed to be duplicated as needed to accommodate all participating firms on a given project.
The Bidders List Form requires mandatory data collection for each bidder, including business name, address, contact person information, phone number, email address, and type of work provided. Additionally, the form collects information regarding Disadvantaged Business Enterprise (DBE) certification status, business age in years and months, and annual gross receipts categorized in ranges from less than $500,000 to over $5,000,000. The primary purpose of this form is to determine the relative availability of certified DBEs and non-DBEs participating in DOT-assisted procurements, thereby supporting LACMTA's compliance with federal disadvantaged business enterprise regulations and promoting transparency in the bidding process.
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Text version
Project Name ___________________________ RFIQ, IFB, or RFP # __________________________
EXHIBIT 4 - BIDDERS LIST FORM
The Los Angeles County Metropolitan Transportation Authority (LACMTA) is required per 49 CFR 26. 11 (c) to create and maintain a comprehensive Bidders List. The Bidders List Form (PRO FORM 132) will be used to determine the relative availability of Disadvantaged Business Enterprises (DBEs) and non-DBEs. The Bidders List is a compilation of bidders, proposers, quoters, subcontractors, manufacturers, and suppliers of materials and services who have submitted bids (to the primary bidder) during the advertising period of a specific acquisition, (whether or not they are successful in their attempt to obtain a contract). Please provide the following mandatory data:
Bidder 1: Business Data Business Name:
Business Address:
Street City State Zip Name of Contact Person:
Phone: Email Address: Type of Work:
Is this firm a certified DBE? a. Yes b. No Age of Business: ________ Years ________ Months
Annual Gross Receipts: a. Less than $500,000 b. $500,000 to $1,000,000 c. $1,000,000 to $2,000,000
d. $2,000,000 to $5,000,000 e. Over $5,000,000
Bidder 2: Business Data Business Name:
Business Address:
Street City State Zip
Name of Contact Person:
Phone: Email Address: Type of Work:
Is this firm a certified DBE? a. Yes b. No Age of Business: ________ Years ________ Months
Annual Gross Receipts: a. Less than $500,000 b. $500,000 to $1,000,000 c. $1,000,000 to $2,000,000
d. $2,000,000 to $5,000,000 e. Over $5,000,000
Bidder 3: Business Data Business Name:
Business Address:
Street City State Zip Name of Contact Person:
Phone: Email Address: Type of Work:
Is this firm a certified DBE? a. Yes b. No Age of Business: ________ Years ________ Months
Annual Gross Receipts: a. Less than $500,000 b. $500,000 to $1,000,000 c. $1,000,000 to $2,000,000
d. $2,000,000 to $5,000,000 e. Over $5,000,000
If necessary this “Bidders List” form can be duplicated to include all firms (DBE and non-DBE) that have submitted a bid, proposal or quote on this DOT-assisted project.
BIDDERS LIST FORM
| Project Name: |
| RFIQ IFB or RFP: |
| Name of Contact Person: |
| c: Off |
| d: Off |
| e: Off |
| Business Name_2: |
| Street_2: |
| City_2: |
| State_2: |
| Zip_2: |
| Name of Contact Person_2: |
| c_2: Off |
| d_2: Off |
| e_2: Off |
| Business Name_3: |
| Street_3: |
| City_3: |
| State_3: |
| Zip_3: |
| Name of Contact Person_3: |
| c_3: Off |
| d_3: Off |
| e_3: Off |
| Email Address1: |
| Years1: |
| Months1: |
| Type of Work1: |
| Phone Number1: |
| Business Name1: |
| Street1: |
| City1: |
| State1: |
| Zip1: |
| Yes1: Off |
| a: Off |
| Phone Number 2: |
| Type of Work 2: |
| Years 2: |
| Months 2: |
| a 2: Off |
| Phone Number 3: |
| Email Address 2: |
| Email Address 3: |
| Type of Work 3: |
| b: Off |
| no 1: Off |
| no2: Off |
| yes 2: Off |
| b_2: Off |
| no 3: Off |
| yes 3: Off |
| b 3: Off |
| a_3: Off |
| Years 3: |
| Months 3: |
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