Form_1._Personal_Professional_Sub-consultant_Disclosure_Form.pdf

PDF 1 MB Posted

Attached to
Traffic School Program Provider and Related Services
Solicitation number
26-061
Issued by
Washington County, Barlow City, Oregon

About this file

This is a Personal/Professional Services Contract Subconsultant Disclosure Form issued by the City of Beaverton for use in response to the Traffic School Program Provider and Related Services Request for Proposal. The form requires proposers to disclose all subconsultants—both certified and non-certified—involved in delivering traffic safety classes to the Beaverton Municipal Court. Proposers must list up to eight subconsultants with their complete legal names, addresses, phone numbers, scope of work descriptions, and dollar values of subcontracts. The proposal submission deadline is May 7, 2026, at 5:00 p.m., with contract award anticipated by June 16, 2026. The contract is anticipated to commence August 1, 2026, for an initial five-year term through July 31, 2031, with potential renewal for additional one-year terms at the City's option. Top-tier proposers will be invited to present on May 18, 2026.

The form requires disclosure of all business certifications held by subconsultants, including Emerging Small Business (ESB), Minority-Owned Business (MBE), Women-Owned Business (WBE), Service-Disabled Veteran-Owned Business (SDV), Disadvantaged Business Enterprise (DBE), and Auxiliary Community-based Disadvantaged Business Enterprise (ACDBE) designations. The City has established an aspirational goal of 15 percent participation of COBID-certified firms in overall contracting activities and requires proposers to demonstrate good faith efforts in utilizing COBID-certified enterprises as subcontractors. The Beaverton Equity Procurement Program participation component is worth 12 points in the initial proposal evaluation phase. This disclosure requirement ensures transparency in subcontracting arrangements and supports the City's commitment to inclusive procurement practices.

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Text version

Company Name: ______________________________________ Project Name: _____________________________________________________

LIST ALL SUBCONSULTANTS —CERTIFIED AND NON-CERTIFIED

ALL SUBCONSULTANTS

(Use the Subconsultants complete legal name)

DESCRIPTION OR SCOPE OF WORK

(TYPE OF WORK TO BE PERFORMED)

DOLLAR VALUE OF

SUBCONTRACT

LIST ALL CERTIFICATIONS

(ESB; MBE, WBE, SDV, DBE, ACDBE)

Name ______________________________________

Address ____________________________________

City/St/Zip __________________________________

Phone ______________________________________

Name ______________________________________

Address ____________________________________

City/St/Zip __________________________________

Phone ______________________________________

Name ______________________________________

Address ____________________________________

City/St/Zip __________________________________

Phone ______________________________________

Name ______________________________________

Address ____________________________________

City/St/Zip __________________________________

Phone ______________________________________

*ESB: Emerging Small Business; MBE: Minority-owned Business; WBE: Women-Owned Business; SDV: Service-Disabled Veteran-Owned Business;

DBE & ACDBE Disadvantaged Business Enterprise Rev 5/6/19

CITY OF BEAVERTON

PERSONAL / PROFESSIONAL SERVICES CONTRACT: SUBCONSULTANT DISCLOSURE FORM 1

ALL SUBCONSULTANTS

(Use the Subconsultants complete legal name)

DESCRIPTION OR SCOPE OF WORK

(TYPE OF WORK TO BE PERFORMED)

DOLLAR VALUE OF

SUBCONTRACT

LIST ALL CERTIFICATIONS

(ESB; MBE, WBE, SDV, DBE, ACDBE)

Name ______________________________________

Address ____________________________________

City/St/Zip __________________________________

Phone ______________________________________

Name ______________________________________

Address ____________________________________

City/St/Zip __________________________________

Phone ______________________________________

Name ______________________________________

Address ____________________________________

City/St/Zip __________________________________

Phone ______________________________________

Name ______________________________________

Address ____________________________________

City/St/Zip __________________________________

Phone ______________________________________

*ESB: Emerging Small Business; MBE: Minority-owned Business; WBE: Women-Owned Business; SDV: Service-Disabled Veteran-Owned Business;

DBE & ACDBE Disadvantaged Business Enterprise Rev 5/6/19

CITY OF BEAVERTON

PERSONAL / PROFESSIONAL SERVICES CONTRACT: SUBCONSULTANT DISCLOSURE FORM 1

LIST ALL SUBCONSULTANT—CERTIFIED AND NON-CERTIFIED

Project Name:
Name:
Address:
CityStZip:
Phone:
Name_2:
Address_2:
CityStZip_2:
Phone_2:
Name_3:
Address_3:
CityStZip_3:
Phone_3:
Name_4:
Address_4:
CityStZip_4:
Phone_4:
Name_5:
Address_5:
CityStZip_5:
Phone_5:
Name_6:
Address_6:
CityStZip_6:
Phone_6:
Name_7:
Address_7:
CityStZip_7:
Phone_7:
Name_8:
Address_8:
CityStZip_8:
Phone_8:
Company Name:
DVoS:
Certifications:
SOW:
SOW_2:
SOW_3:
Certifications_3:
Certifications_2:
Certifications_4:
SOW_4:
SOW_5:
SOW_6:
SOW_7:
SOW_8:
Certifications_5:
Certifications_6:
Certifications_7:
Certifications_8:
DVoS_5:
DVoS_6:
DVoS_7:
DVoS_8:
DVoS_2:
DVoS_3:
DVoS_4:

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