FORM 1 - SBE-DVBE SUBS & SUPPLIERS.pdf

PDF 157 KB Posted Aug 21, 2026

Attached to: El Monte Mobility Hub Climate Resilience Project - CBO Partnership Opportunity
Solicitation number: PS145019
Issued by: California

About this file

Written by GovTribe AI · Aug 24, 2026

This is a Small Business Enterprise (SBE) and Disabled Veteran Business Enterprise (DVBE) subcontractor and supplier disclosure form for the Los Angeles County Metropolitan Transportation Authority (LACMTA). The form is completed by prime contractors to document all first-tier subcontractors and suppliers to be utilized on non-construction projects. Contractors must list every business engaged, including both SBE/DVBE and non-SBE/DVBE entities, with associated contract values and appropriate credits. For proposals to be responsive, bidders must submit a completed Attachment A form for each business listed, which validates SBE/DVBE credits and ensures consistency with the SBE/DVBE commitment outlined in the affidavit and related contract documents.

LACMTA applies differential credit calculations based on business classification: suppliers providing materials, equipment, or supplies receive 60% credit toward SBE/DVBE goals, while distributors receive 40% credit; brokers receive credit only for broker or commission markup fees. All subcontractors listed on Form 1 that are themselves subcontracting work must complete Attachment A and submit lower-tier subcontractor information. LACMTA reviews all submitted documentation for consistency across Forms 1 through 6 and reserves the right to request clarification for any discrepancies between the form information and attachments. The contractor remains obligated to meet the SBE/DVBE commitment stated in the SBE/DVBE Affidavit, which LACMTA enforces under the executed contract.

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Other files

File	Type	Posted
EXHIBIT G - APPROVED SUBCONTRACTORS AND SUPPLIERS.pdf	PDF	Aug 21, 2026
EXHIBIT 12 - MISCELLANEOUS (RESERVED).pdf	PDF	Aug 21, 2026
EXHIBIT 8 - ETHICS DECLARATION.pdf	PDF	Aug 21, 2026
FORM 6 - SBE-DVBE REGULAR DEALER DIST AFFIRMATION.pdf	PDF	Aug 21, 2026
EXHIBIT 5 - PROPOSAL LETTER.pdf	PDF	Aug 21, 2026
EXHIBIT H - MISCELLANEOUS (RESERVED).pdf	PDF	Aug 21, 2026
EXHIBIT I - RESERVED.pdf	PDF	Aug 21, 2026
EXHIBIT C - WORK-COMPLETION SCHEDULE (RESERVED).pdf	PDF	Aug 21, 2026
EXHIBIT D - DEOD CONTRACT COMPLIANCE MANUAL.pdf	PDF	Aug 21, 2026
EXHIBIT 3 - EVALUATION CRITERIA.pdf	PDF	Aug 21, 2026
EXHIBIT 2.1 - PRICING SCHEDULE.xlsx	XLSX spreadsheet	Aug 21, 2026
RFP No. PS145019.pdf	PDF	Aug 21, 2026
FORM 5 - BIDDERS LIST FORM.pdf	PDF	Aug 21, 2026
FORM 3 - BUSINESS DATA SHEET.pdf	PDF	Aug 21, 2026
EXHIBIT A - SCOPE OF SERVICES.pdf	PDF	Aug 21, 2026
EXHIBIT 4 - LIST OF CERTIFIED FIRMS (RESERVED).pdf	PDF	Aug 21, 2026
EXHIBIT F - RELEASE OF CLAIMS.pdf	PDF	Aug 21, 2026
EXHIBIT 6 - LIST OF CURRENT CONTRACTS.pdf	PDF	Aug 21, 2026
FORM 2 - AFFIDAVIT.pdf	PDF	Aug 21, 2026
EXHIBIT B - PRICING AGREEMENT.pdf	PDF	Aug 21, 2026
FORM 4 - SBE-DVBE AFFIRMATION.pdf	PDF	Aug 21, 2026
EXHIBIT E-2 - PAYMENT CERTIFICATION (FINAL).pdf	PDF	Aug 21, 2026
EXHIBIT 9 - GENERAL CERTIFICATIONS.pdf	PDF	Aug 21, 2026
EXHIBIT 11 - NONCOLLUSION AFFIDAVIT (RESERVED).pdf	PDF	Aug 21, 2026
EXHIBIT 2 - FORM 60.xls	XLS spreadsheet	Aug 21, 2026
EXHIBIT 7 - LIST OF COMPLETED CONTRACTS.pdf	PDF	Aug 21, 2026
EXHIBIT 10 - CERTIFICATE OF COMPLIANCE.pdf	PDF	Aug 21, 2026
EXHIBIT 2 - FORM 60 INSTRUCTIONS.pdf	PDF	Aug 21, 2026
EXHIBIT E-1 - PAYMENT CERTIFICATION (CONTINUOUS).pdf	PDF	Aug 21, 2026

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FORM 1 – NON-CONSTRUCTION – PROPOSED SUBCONTRACTORS & SUPPLIERS

TO BE COMPLETED BY CONTRACTOR ONLY

The Prime is requested to list ALL first-tier businesses which include SBE/DVBEs & non-SBE/DVBEs to be utilized on this project

IFB/RFP/RFIQ Number: Project Name:

Total Proposal/Bid Price: Proposal/Bid Due Date:

Printed Name and Title: Authorized Signature/Date:

A B C D E F G H I J

NAME OF BUSINESS

(Subcontractors)

SBE

(Y/N)

DVBE

LSBE

Supplier1

Distributor2

Broker3

Proposal/Bid

Price Breakdown

SBE Credit $ DVBE Credit $

Prime

Su bc on tra ct or s

Total: (Should match Total Prop/Bid Price on top of pg.) (Total SBE Commitment) (Total DVBE Commitment) 1If an SBE/DVBE business is a supplier providing materials/equipment/supplies, only sixty percent (60%) of the cost will be credited toward the SBE/DVBE goal. LACMTA will take 60% of the cost for materials/equipment/supplies listed in Column G to credit for SBE/DVBE participation. If an SBE/DVBE supplier, list 60% of the Subcontractor Contract Price breakdown in Column H in Columns I or J.

2If an SBE/DVBE business is Distributor, only forty percent (40%) of the cost will be credited toward the SBE/DVBE goal. LACMTA will take 40% of the cost for materials/equipment/supplies listed in Column H to credit for SBE/DVBE participation. If an SBE/DVBE distributor, list 40% of the Subcontractor Contract Price breakdown in Column H in Columns I or J.

3If an SBE/DVBE business is providing brokering services, only the broker/commission (mark-up) fees will be credited toward the SBE/DVBE goal. If a broker, only list broker/commission (mark-up) fees in Column I or J.

ATTACHMENT A TO FORM 1 – NON-CONSTRUCTION: PROPOSED LOWER TIER SUBCONTRACTORS &

INSTRUCTIONS FOR CONTRACTOR:

The purpose of this Attachment A is to validate the SBE/DVBE credit on Form 1 – Non-Construction and the SBE/DVBE commitment in the SBE/DVBE Affidavit.

1. Send this Attachment A to each business listed on Form 1 – Non-construction and ask each such business to complete Attachment A and return to the Bidder/Proposer.

2. Obtain all Attachment A forms and verify that the information provided in the Attachments is consistent with the aggregated numbers in Form 1 – Non-construction and the SBE/DVBE commitment listed in the SBE/DVBE Affidavit. Verify that the information provided in the Attachment A forms is consistent with the information provided in Forms 2 to 6.

3. Attach all Attachment A forms received to Form 1 – Non-Construction as Attachment A. For a Bid/Proposal to be responsive, you must submit with your Bid/Proposal a completed Attachment A for each business listed on Form 1 – Non-Construction.

4. If there is any discrepancy or conflict between the information listed on any of Forms 1 to 6 and the information in the Attachments, LACMTA may issue requests for clarification seeking information or clarification from the Contractor and the business in accordance with this Contractor. In all events, the Contractor shall be required to meet the SBE/DVBE commitment listed in the SBE/DVBE Affidavit, which will be enforced by LACMTA under the Contract.

INSTRUCTIONS FOR EACH SUBCONTRACTOR LISTED ON FORM 1 THAT IS SUBCONTRACTING WORK:

1. Complete this Attachment A to Form 1 – Non-Construction to the best of your knowledge and information.

2. Complete the row titled "Your Firm" with name in column A and complete the information in columns B to H for your contract.

3. List each lower-tier Subcontractor (SBE/DVBE or non-SBE/DVBE) that you will be sub-contracting Work to in column A and complete the information in columns B through H for each of the lower-tier Subcontractors listed in column A.

ATTACHMENT A TO FORM 1 – NON-CONSTRUCTION: PROPOSED LOWER TIER SUBCONTRACTORS & SUPPLIERS All Subcontractors listed on Form 1 – Non-Construction that are subcontracting work are requested to list ALL lower-tier businesses, which include SBE/DVBEs & non- SBE/DVBEs to be utilized for the project.

IFB/RFP/RFIQ Number: Project Name:

Total Proposal/Bid Price: Proposal/Bid Due Date:

Printed Name and Title: Authorized Signature/Date:

A B C D E F G H I J

NAME OF BUSINESS

(Subcontractors)

SBE

DVBE

LSBE

Supplier1

Distributor2

Broker3

Proposal/Bid

Price Breakdown

SBE Credit $ DVBE Credit $

Prime

Su bc on tra ct or s

4Appropriate credit will be reviewed by LACMTA.

IFBRFPRFIQ Number:

undefined_2:

Total ProposalBid Price:

ProposalBid Due Date:

Printed Name and Title_3:

NAME OF BUSINESS SubcontractorsPrime:

SBE YNPrime:

DVBE YNPrime:

LSBE YNPrime:

Supplier1 YNPrime:

Distributor2 YNPrime:

Broker3 YNPrime:

ProposalBid Price Breakdown Prime:

SBE Credit Prime:

DVBE Credit Prime:

NAME OF BUSINESS Subcontractors1:

SBE YN1_3:

DVBE YN1_3:

LSBE YN1_3:

Supplier1 YN1:

Distributor2 YN1:

Broker3 YN1:

ProposalBid Price Breakdown 1:

SBE Credit 1:

DVBE Credit 1:

NAME OF BUSINESS Subcontractors2:

SBE YN2_3:

DVBE YN2_3:

LSBE YN2_3:

Supplier1 YN2:

Distributor2 YN2:

Broker3 YN2:

ProposalBid Price Breakdown 2:

SBE Credit 2:

DVBE Credit 2:

NAME OF BUSINESS Subcontractors3:

SBE YN3_3:

DVBE YN3_3:

LSBE YN3_3:

Supplier1 YN3:

Distributor2 YN3:

Broker3 YN3:

ProposalBid Price Breakdown 3:

SBE Credit 3:

DVBE Credit 3:

NAME OF BUSINESS Subcontractors4:

SBE YN4_3:

DVBE YN4_3:

LSBE YN4_3:

Supplier1 YN4:

Distributor2 YN4:

Broker3 YN4:

ProposalBid Price Breakdown 4:

SBE Credit 4:

DVBE Credit 4:

NAME OF BUSINESS Subcontractors5:

SBE YN5_2:

DVBE YN5_2:

LSBE YN5_2:

Supplier1 YN5:

Distributor2 YN5:

Broker3 YN5:

ProposalBid Price Breakdown 5:

SBE Credit 5:

DVBE Credit 5:

NAME OF BUSINESS Subcontractors6:

SBE YN6_2:

DVBE YN6_2:

LSBE YN6_2:

Supplier1 YN6:

Distributor2 YN6:

Broker3 YN6:

ProposalBid Price Breakdown 6:

SBE Credit 6:

DVBE Credit 6:

NAME OF BUSINESS Subcontractors7:

SBE YN7:

DVBE YN7:

LSBE YN7:

Supplier1 YN7:

Distributor2 YN7:

Broker3 YN7:

ProposalBid Price Breakdown 7:

SBE Credit 7:

DVBE Credit 7:

Text2:

Text3:

Text4:

IFBRFPRFIQ Number_2:

undefined_3:

Total ProposalBid Price_2:

ProposalBid Due Date_2:

Printed Name and Title_4:

NAME OF BUSINESS SubcontractorsPrime_2:

SBE YNPrime_2:

DVBE YNPrime_2:

LSBE YNPrime_2:

Supplier1 YNPrime_2:

Distributor2 YNPrime_2:

Broker3 YNPrime_2:

ProposalBid Price Breakdown Prime_2:

SBE Credit Prime_2:

DVBE Credit Prime_2:

NAME OF BUSINESS Subcontractors1_2:

SBE YN1_4:

DVBE YN1_4:

LSBE YN1_4:

Supplier1 YN1_2:

Distributor2 YN1_2:

Broker3 YN1_2:

ProposalBid Price Breakdown 1_2:

SBE Credit 1_2:

DVBE Credit 1_2:

NAME OF BUSINESS Subcontractors2_2:

SBE YN2_4:

DVBE YN2_4:

LSBE YN2_4:

Supplier1 YN2_2:

Distributor2 YN2_2:

Broker3 YN2_2:

ProposalBid Price Breakdown 2_2:

SBE Credit 2_2:

DVBE Credit 2_2:

NAME OF BUSINESS Subcontractors3_2:

SBE YN3_4:

DVBE YN3_4:

LSBE YN3_4:

Supplier1 YN3_2:

Distributor2 YN3_2:

Broker3 YN3_2:

ProposalBid Price Breakdown 3_2:

SBE Credit 3_2:

DVBE Credit 3_2:

NAME OF BUSINESS Subcontractors4_2:

SBE YN4_4:

DVBE YN4_4:

LSBE YN4_4:

Supplier1 YN4_2:

Distributor2 YN4_2:

Broker3 YN4_2:

ProposalBid Price Breakdown 4_2:

SBE Credit 4_2:

DVBE Credit 4_2:

NAME OF BUSINESS Subcontractors5_2:

SBE YN5_3:

DVBE YN5_3:

LSBE YN5_3:

Supplier1 YN5_2:

Distributor2 YN5_2:

Broker3 YN5_2:

ProposalBid Price Breakdown 5_2:

SBE Credit 5_2:

DVBE Credit 5_2:

NAME OF BUSINESS Subcontractors6_2:

SBE YN6_3:

DVBE YN6_3:

LSBE YN6_3:

Supplier1 YN6_2:

Distributor2 YN6_2:

Broker3 YN6_2:

ProposalBid Price Breakdown 6_2:

SBE Credit 6_2:

DVBE Credit 6_2:

NAME OF BUSINESS Subcontractors7_2:

SBE YN7_2:

DVBE YN7_2:

LSBE YN7_2:

Supplier1 YN7_2:

Distributor2 YN7_2:

Broker3 YN7_2:

ProposalBid Price Breakdown 7_2:

SBE Credit 7_2:

DVBE Credit 7_2:

Text5:

Text6:

Text7:

File details come from the government source that posted it. Updated Aug 24, 2026.