EXHIBIT 4 - BIDDERS LIST FORM.pdf

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Attached to
Security Asset Manager (SAM) Key Safe
Solicitation number
OP143616
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-assisted projects. The form serves as a standardized template to compile comprehensive data on all bidders, proposers, quoters, subcontractors, manufacturers, and suppliers who submit bids during the advertising period of a specific acquisition, regardless of bid success. The document captures mandatory business information for up to three bidders per page, including business name, address, contact person details, phone number, email address, and type of work performed.

The form collects critical data to determine the relative availability of Disadvantaged Business Enterprises (DBEs) and non-DBE firms in the procurement process. Required information includes DBE certification status, business age in years and months, and annual gross receipts categorized into five brackets ranging from less than $500,000 to over $5,000,000. The form is designed to be duplicated as necessary to accommodate all participating firms on a given project. This bidders list serves a compliance and recordkeeping function for LACMTA's federal transportation funding requirements and supports diversity monitoring in the competitive bidding process.

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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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