EXHIBIT 5 - BIDDERS LIST FORM.pdf
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- Attached to
- CARBON STRIPS
- Solicitation number
- MA141253
- Issued by
- California
About this file
This is a Bidders List Form (PRO FORM 132) issued by the Los Angeles County Metropolitan Transportation Authority (LACMTA) in compliance with 49 CFR 26.11(c) federal requirements. The form serves as a standardized template for documenting all bidders, proposers, quoters, subcontractors, manufacturers, and suppliers who submit bids during the advertising period of Department of Transportation-assisted projects, regardless of bid success. The document does not specify a particular project, response date, or award timeline, as it functions as a general form to be completed for each individual acquisition.
The form requires mandatory data collection for each bidder, including business name, address, contact person information, phone number, email address, and type of work provided. Respondents must indicate Disadvantaged Business Enterprise (DBE) certification status and provide business age in years and months, along with annual gross receipts categorized into five brackets ranging from less than $500,000 to over $5,000,000. The form accommodates a minimum of three bidders per page, with instructions allowing duplication to capture all participating firms. This compilation of bidder information enables LACMTA to determine the relative availability of DBEs and non-DBEs within the contractor and supplier market for DOT-assisted projects.
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Text version
Project Name ____________________________ RFIQ, IFB, or RFP # ___________________________
EXHIBIT 5 - 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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