Form_1._Personal_Professional_Sub-consultant_Disclosure_Form.pdf
PDF 1023 KB Posted
- Attached to
- Private Utility Locating Services
- Solicitation number
- 24-050
- Issued by
- Washington County, Barlow City, Oregon
About this file
The document is a City of Beaverton Personal/Professional Services Contract Subconsultant Disclosure Form 1, specifically designed for listing all subconsultants (both certified and non-certified) for a potential contract. The form provides a structured template for prime contractors to disclose detailed information about their proposed subconsultants, including each subconsultant's complete legal name, address, contact information, description of work to be performed, dollar value of subcontract, and their specific business certifications.
The form includes multiple rows to list subconsultants with various certification categories such as Emerging Small Business (ESB), Minority-owned Business (MBE), Women-Owned Business (WBE), Service-Disabled Veteran-Owned Business (SDV), and Disadvantaged Business Enterprise (DBE & ACDBE). This suggests the City of Beaverton has a structured approach to promoting diversity and inclusion in its contracting processes, allowing businesses from different backgrounds and ownership structures to participate in municipal procurement opportunities. The form is part of the documentation for the Private Utility Locating Services project, which requires contractors to transparently detail their subconsultant relationships and support the city's strategic contracting objectives.
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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
X X X X
| Project Name: |
| Name: |
| Address: |
| CityStZip: |
| Phone: |
| Name_2: |
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| CityStZip_7: |
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| Name_8: |
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| CityStZip_8: |
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| Company Name: |
| DVoS: |
| Certifications: |
| SOW: |
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| DVoS_5: |
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File details come from the government source that posted it. Updated .