FLHSMV-ITB-004-26 ATTACHMENT F .pdf
PDF 68 KB Posted
- Attached to
- Vehicle Utility Boxes
- Solicitation number
- ITB-14007
- Issued by
- Leon County, Florida
About this file
Subcontractor Utilization Form Summary
This document is a Subcontractor Utilization Form issued by the Florida Department of Highway Safety and Motor Vehicles for Solicitation No. FLHSMV-ITB-004-26. The form requires all bidders to disclose their use of subcontractors at the time of bid submission, with failure to disclose subcontractor utilization potentially rendering the bid nonresponsive. Bidders must certify the accuracy of the information provided and confirm direct contact with any named subcontractor firms regarding project participation.
The form includes a table for bidders to list subcontractors by name, address, telephone number, percentage of utilization, Certified Business Enterprise (CBE) code, and Federal Employer Identification Number (FEIN). The CBE codes distinguish between certified and non-certified minority, women-owned, and service-disabled veteran business enterprises, including African American, Hispanic, Asian-American, Native American, and non-minority women-owned categories. Bidders have the option to indicate that no subcontractors will be utilized to perform any services in response to the ITB, and may attach additional pages as necessary if additional subcontractor information is required.
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Text version
ATTACHMENT F
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
SUBCONTRACTOR UTILIZATION FORM
BIDDER NAME:__________________________ SOLICITATION NO: FLHSMV-ITB-004-26
FEIN NO:_______________________________ DATE:____________
All bidders shall complete and submit the following information as requested in this form at time of submission. Failure to disclose subcontractor utilization may deem the bid non-responsive.
The bidder certifies this form accurately represents its solicitation and utilization or non-utilization, as indicated, of the companies listed below for performance of work if awarded contract. The bidder also certifies he/she has had direct contact with the named firms regarding participation on this project.
SUBCONTRACTOR UTILIZATION
*Certified Business Enterprise (CBE) Codes:
Certified Codes: H - African American (Certified); I - Hispanic (Certified); J - Asian-American (Certified); K - Native American (Certified); M - Non-Minority (White) Women (Certified); W - Service-Disabled Veteran Business (Certified)
Non-Certified Codes: A - Non-Minority; N - African American (Non-Certified); O - Hispanic (Non-Certified); P - Asian- American (Non-Certified); Q - Native American (Non-Certified); R - Non-Minority (White) Women (Non-Certified); Y - Service-Disabled Veteran Business (Non-Certified)
No subcontractor(s) will be utilized to perform any services in response to this ITB.
NOTE: Attach additional pages, if necessary.
BIDDER MUST SIGN EACH ADDITIONAL SHEET TO CERTIFY ITS CONTENT AND
COMPLETION OF FORM.
AUTHORIZED REPRESENTATIVE SIGNATURE:_________________________________________________
TITLE:_____________________________________________________________________________________________
FLHSMV-ITB-004-26, ATTACHMENT F, Page 1 of 1
UTILIZATION
NAME OF SUBCONTRACTOR ADDRESS
TELEPHONE
NUMBER
CBE
CODE*
FEIN NO.
File details come from the government source that posted it. Updated .