Exhibit 4- Schedule 1 - List of Proposed ACDBE Firms - Amendment No. 2.doc

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Attached to
IFB PB 18-10 Rental Car Lease & Concession
Solicitation number
IFB 120 PB 18-10 RENTAL CAR 6
Issued by
Palm Beach County, Florida

About this file

This is Schedule 1 of an Invitation for Bid (IFB PB 18-10) for a Rental Car Lease & Concession opportunity issued by the State of Florida, Department of Airports. The form serves as a template for bidders to document their proposed Airports Concession Disadvantaged Business Enterprise (ACDBE) firms and their anticipated participation levels. Bidders must list each ACDBE firm by name, address, and phone number, designate the firm's role (Prime Contractor, Subcontractor, Supplier, Manufacturer, or Joint Venture), and specify the percentage of participation broken down by race/gender categories (Black, Hispanic, Women, and Other). The form requires bidders to calculate and report total ACDBE participation as a percentage of total purchases of goods and services, with all percentages supported by corresponding Schedules 2 documentation.

Bidders are obligated to confirm that all identified ACDBE firms are certified through the State of Florida's Unified Certification Program, as only certified firms count toward attainment of the ACDBE participation goal. By executing the form, bidders commit to utilizing the listed ACDBE firms pursuant to the Concession Agreement, and any substitutions of ACDBE firms during the contract term require prior written approval from the Department of Airports. This schedule was revised per Amendment No. 2 to IFB PB 18-10.

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Text version

SCHEDULE 1

LIST OF PROPOSED ACDBE FIRMS

Name of Bidder: _____________________________________________

Phone No.: __________________________ Fax No: ___________________

Contact Person: __________________________________________________

E-mail Address: _________________________________________________

Address: ________________________________________________________

Anticipated Percentage of ACDBE Participation by Race/Gender(1)

Name, Address &

Phone No. of

ACDBE Firm(2) Description of

Type of Work

Classification

(Check applicable box)

Black
Hispanic
Women
Other

(Please Specify)

□ Prime Contractor

□ Subcontractor

□ Supplier

□ Manufacturer

□ Joint Venture

_________%
________%
__________%

□ Prime Contractor

□ Supplier

□ Manufacturer

□ Joint Venture

________%
_________%
________%
__________%

□ Prime Contractor

□ Supplier

□ Manufacturer

□ Joint Venture

________%
_________%
________%
__________%

Total Percentage of ACDBE Participation(3)

________%
+________%
+________%
+__________%
=__________%

Notes:

1.

The percentages listed on this form for each ACDBE Firm must be supported by the percentage included on Schedule 2, “Letter of Intent to Perform as an Airports Concession Disadvantaged Business Enterprise”, in order to be counted toward attainment of the ACDBE goal.

2.

It is the obligation of bidder to confirm that firms identified on this form must be certified as an ACDBE by the State of Florida’s Unified Certification Program. Firms not certified by the State of Florida’s Unified Certified Program as an ACDBE will not be counted toward attainment of the goal.

3.

ACDBE participation is measured as a percentage of total purchases of goods and services.

By signing this form the undersigned Bidder is committing to utilize the above-referenced ACDBE Firms pursuant to the Concession Agreement. Substitutions of ACDBE Firms during the term of the Concession Agreement shall be subject to prior written approval of the Department of Airports.

By: _______________________________________________

Signature

*Additional sheets may be used if necessary.

Print Name/Title of Person Executing on Behalf of the Bidder

Date:______________________________________________

Revised per Amendment No. 2 to IFB PB 18-10

File details come from the government source that posted it. Updated .