FORM 1 - SBE SUBCONTRACTORS & SUPPLIERS.pdf
PDF 240 KB Posted
- Attached to
- Community Relations Services Bench
- Solicitation number
- PS145468
- Issued by
- California
About this file
This document contains Small Business Enterprise (SBE) subcontractor and supplier reporting forms required by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for state and local contract opportunities, specifically a Community Relations Services Bench contract in California. The forms establish the framework for prime contractors to identify and report all SBE businesses at any tier that will be utilized on the project and for which SBE credit is being sought. Prime contractors must complete Form 1 to list all SBE subcontractors and suppliers, along with Attachment A forms completed by each SBE business detailing their lower-tier subcontractors and work to be performed. Bids must include these completed forms to be deemed responsive, with all information cross-referenced and consistent across Forms 1 through 5 and the SBE Affidavit. The solicitation also includes Form 1B for listing all first-tier subcontractors, both SBE and non-SBE, which simultaneously fulfills California Subletting and Subcontracting Fair Practices Act requirements.
SBE credit calculations follow specific formulas based on business classification: suppliers receive credit for 60 percent of contract costs, distributors receive 40 percent, brokers receive credit only for fees and commissions, and manufacturers receive full credit. Prime contractors remain subject to termination and substitution requirements for any SBE firm listed on the project, and work subcontracted by SBE firms to non-SBE businesses does not count toward SBE goals. The forms require documentation of each business's SBE status, classification type, tier level, percentage of self-performed work, local small business enterprise (LSBE) status, and dollar values of contracts. LACMTA reserves the right to issue clarification requests regarding discrepancies between the forms and the SBE commitment listed in the affidavit, which will be enforced under the contract.
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FORM 1 - SBE SUBCONTRACTORS & SUPPLIERS
TO BE COMPLETED BY PRIME ONLY
The Prime (Offeror) is required to list ALL SBE businesses, of any tier, to be utilized on this project for whom Prime is seeking SBE Credit. For a bid to be responsive, the Prime (Offeror) must complete this form and submit the completed form with its bid. The form should be complete in accordance with the instructions on this form and in the solicitation, using care so that the information provided in this form is consistent with the information provided in Forms 2 to 5 and the SBE commitment in the SBE Affidavit. If there is any discrepancy or conflict between the information listed on any of Forms 2 to 5 and the information in this Form 1, LACMTA may issue requests for clarification seeking information or clarification from the Prime (Offeror) in accordance with this solicitation. In all events, Prime shall be required to meet the SBE commitment listed in the SBE Affidavit, which will be enforced by LACMTA under the Contract. Each SBE business listed on Form 1 shall complete Attachment A to this Form.
Solicitation Number: Total Prime Bid Price:
Project Name: Authorized Signature / Date:
Bid Due Date: Printed Name and Title:
A1 B C D E F G H I2 J K
NAME OF BUSINESS
Manufacturer
(Y/N)
Supplier?3 (Y/N)
Distributor4
(Y/N) Broker5 (Y/N)
Tier (First/
Second/ Third, etc.)
LSBE
(Y/N)
% work intended to be self-performed
If not first-tier, name of business with whom listed business is contracted
Dollar value of listed business’ contract
SBE Credit $6 (Suppliers take 60% of price;
Distributors take 40% of price;
Brokers, fees & commission only)
Your Firm
SB
E
Su bc on tra ct or s
1.
2.
3.
4.
5.
6.
7.
Total:
1For any SBE firm listed on this Project, the Prime is subject to the Termination/Substitution requirements in the solicitation.
2Prime may be required to list businesses not listed on the Subcontractor Listing Form (e.g., a low dollar value non-SBE subcontractor who contracts with a SBE business).
3If a SBE business is a supplier providing materials/supplies, only sixty percent (60%) of the cost will be credited toward the SBE goal. LACMTA will take 60% of the cost for materials/supplies listed in Column J to credit for SBE participation. If a SBE supplier, list 60% of the Bid Price breakdown in Column K. Appropriate credit will be determined by LACMTA.
4If a SBE business is Distributor, only forty percent (40%) of the cost will be credited toward the SBE goal. LACMTA will take 40% of the cost for materials/supplies listed in Column J to credit for SBE participation. If a SBE distributor, list 40% of the Bid Price breakdown in Column K. Appropriate credit will be determined by LACMTA.
5If a SBE business is providing brokering services, only the broker/commission (mark-up) fees will be credited toward the SBE goal. If a broker, only list broker/commission (mark-up) fees in Column K.
6The Prime is reminded that work that a SBE subcontracts to a non-SBE firm does not count toward the SBE goal. See Section 300 (Commercial Useful Function and Counting SBE Participation) of the SBE Instructions to Proposers (Federal). All lower-tier Subcontractors for each SBE firm listed on this form must be identified on Attachment A.
ATTACHMENT A TO FORM 1: SUPPORTING INFORMATION FROM SBE SUBCONTRACTOR
INSTRUCTIONS FOR PRIME (Offeror):
The purpose of this Attachment A is to validate the SBE credit on Form 1 and the SBE commitment in the SBE Affidavit.
1. Send this Attachment A to each SBE business listed on Form 1 and ask each such SBE business to complete Attachment A and return to the Prime.
2. Obtain all Attachment A forms and verify that the information provided in the Attachments is consistent with the aggregated numbers in Form 1 and the SBE commitment listed in the SBE Affidavit. Verify that the information provided in the Attachment A forms is consistent with the information provided in Forms 2 to 5.
3. The Attachment A forms obtained from the SBE businesses listed on Form 1 may include businesses not listed on the Subcontractor Listing Form (e.g., a low dollar value non-SBE subcontractor who contracts with the SBE business).
4. Attach all Attachment A forms received to Form 1 as Attachment A. For a bid to be responsive, you must submit with your bid a completed Attachment A for each SBE business listed on Form 1.
5. If there is any discrepancy or conflict between the information listed on any of Forms 1 to 5 and the information in the Attachments, LACMTA may issue requests for clarification seeking information or clarification from the Prime (Offeror) and the SBE in accordance with this solicitation. In all events, Prime shall be required to meet the SBE commitment listed in the SBE Affidavit, which will be enforced by LACMTA under the Contract.
INSTRUCTIONS FOR EACH SBE SUBCONTRACTOR LISTED ON FORM 1 THAT IS SUBCONTRACTING WORK:
1. Complete this Attachment A to Form 1 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 E and G to I for your contract.
3. List each lower-tier Subcontractor (SBE or non-SBE) that you will be subcontracting Work to in column A and complete the information in columns B through I for each of the Subcontractors listed in column A.
ATTACHMENT A TO FORM 1: SUPPORTING INFORMATION FROM SBE SUBCONTRACTOR
Project Name:
Your Prime Name:
Your Business Name:
Subcontractor Bid Price:
Printed Name and Title: Authorized Signature1 / Date:
A B C D E F G H I J K
NAME OF BUSINESS SBE?
(Y/N)
Manufacture r
(Y/N)
Supplier2 (Y/N)
Distributor3 (Y/N)
Broker4 (Y/N)
LSBE
(Y/N)
Directly contracting through your firm or at a lower tier?
(Direct/lower)
If not first-tier, name of business with whom listed business is contracted
Dollar value of listed business contract5
SBE Credit $6 (Suppliers take 60% of price;
Distributors take 40% of price;
Brokers, fees & commission only)
Your Firm
Lo w er -T ie r
Su bc on tra ct or s 1.
2.
3.
4.
5.
1To be signed by the authorized signatory of the applicable SBE business listed in Form 1.
2If a SBE business is a Supplier providing materials/equipment/supplies, only sixty percent (60%) of the cost will be credited toward the SBE goal. LACMTA will take 60% of the cost for materials/equipment/supplies listed in Column J to credit for SBE participation. If a SBE supplier, please list 60% of the sub-bid price breakdown in Column K. Appropriate credit will be determined by LACMTA.
3If a SBE business is Distributor, only forty-percent (40%) of the cost will be credited toward the SBE goal. LACMTA will take 40% of the cost for materials/supplies listed in Column J to credit for SBE participation. If a SBE distributor, list 40% of the Bid Price breakdown in Column K. Appropriate credit will be determined by
LACMTA.
4If a SBE business is providing brokering services, only the broker/commission (mark-up) fees will be credited toward the SBE goal. If a broker, only list broker/commission (mark-up) fees in Column K.
6The Subcontractor is reminded that work that a SBE subcontracts to a non-SBE firm does not count toward the SBE goal. See Section 300 (Commercial Useful Function and Counting SBE Participation) of the SBE Instructions to Proposers (Federal).
For any SBE firm listed on Form 1 for this Project, the Prime is subject to the Termination/Substitution requirements in the DEOD Contract Compliance Manual.
FORM 1B - PROPOSED SUBCONTRACTORS & SUPPLIERS
TO BE COMPLETED BY PRIME ONLY
The Prime is requested to list ALL first-tier businesses which include SBEs & Non-SBEs to be utilized on this project. Completion of this form and Form 3, Business Data Sheet also fulfills the requirements of the California Subletting and Subcontracting Fair Practices Act.
IFB/RFP/RFIQ Number: Project Name:
Project Name: Proposal/Bid Due Date:
Total Proposal/Bid Price Authorized Signature/Date
A B C D E F G
NAME OF BUSINESS SBE?
(Y/N)
Manufacturer?
(Y/N)
Supplier?1
(Y/N) Broker?2
(Y/N) Proposal/Bid Price Breakdown $
SBE Credit $ (if supplier, take 60% of price;
if broker, fess and commission only)
Your Firm
Su bc on tra ct or s
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Total:
(Should match Total Proposal/Bid Price listed on top of page) (Total SBE Commitment) 1If an SBE business is a supplier providing materials/supplies, only sixty-percent (60%) of the cost will be credited toward the SBE goal. Metro will take 60% of the cost for materials/supplies listed in Column F to credit for SBE participation. If an SBE supplier, please list 60% of the Proposal Price in Column G.
2If an SBE business is providing brokering services, only the broker/commission (mark-up) fees will be credited toward the SBE goal. If a broker, please only list broker/commission (mark-up) fees in Column G. Appropriate credit will be reviewed by Metro according to 49 CFR Part 26.55
| TABLE 1 - SBE COMMITMENT FORMS |
| SUBCONTRACTOR LISTING FORM FOR IFB ONLY |
| FORM 1 - SBE SUBCONTRACTORS & SUPPLIERS |
| ATTACHMENT A TO FORM 1: SUPPORTING INFORMATION FROM SBE SUBCONTRACTOR |
| ATTACHMENT A TO FORM 1: SUPPORTING INFORMATION FROM SBE SUBCONTRACTOR |
| FORM 2 - COMMERCIALLY USEFUL FUNCTION AFFIDAVIT |
| FORM 3 - BUSINESS DATA SHEET Page 1 of 2 |
| FORM 4 – SBE AFFIRMATION |
| SBE Set-Aside Form 1 (002).pdf |
| FORM 1 - PROPOSED SUBCONTRACTORS & SUPPLIERS |
| TO BE COMPLETED BY PRIME ONLY |
| Total Prime Bid Price: |
| Solicitation Number 1: |
| Solicitation Number 2: |
| Solicitation Number 3: |
| Printed Name and Title: |
| Manufacturer YNYour Firm: |
| Supplier3 YNYour Firm: |
| Distributor4 YNYour Firm: |
| Broker5 YNYour Firm: |
| Tier First Second Third etcYour Firm: |
| LSBE YNYour Firm: |
| work intended to be self performedYour Firm: |
| If not firsttier name of business with whom listed business is contractedYour Firm: |
| Dollar value of listed business contractYour Firm: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission onlyYour Firm: |
| Manufacturer YN1: |
| Supplier3 YN1: |
| Distributor4 YN1: |
| Broker5 YN1: |
| Tier First Second Third etc1: |
| LSBE YN1: |
| work intended to be self performed1: |
| If not firsttier name of business with whom listed business is contracted1: |
| Dollar value of listed business contract1: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only1: |
| Manufacturer YN2: |
| Supplier3 YN2: |
| Distributor4 YN2: |
| Broker5 YN2: |
| Tier First Second Third etc2: |
| LSBE YN2: |
| work intended to be self performed2: |
| If not firsttier name of business with whom listed business is contracted2: |
| Dollar value of listed business contract2: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only2: |
| Manufacturer YN3: |
| Supplier3 YN3: |
| Distributor4 YN3: |
| Broker5 YN3: |
| Tier First Second Third etc3: |
| LSBE YN3: |
| work intended to be self performed3: |
| If not firsttier name of business with whom listed business is contracted3: |
| Dollar value of listed business contract3: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only3: |
| Manufacturer YN4: |
| Supplier3 YN4: |
| Distributor4 YN4: |
| Broker5 YN4: |
| Tier First Second Third etc4: |
| LSBE YN4: |
| work intended to be self performed4: |
| If not firsttier name of business with whom listed business is contracted4: |
| Dollar value of listed business contract4: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only4: |
| Manufacturer YN5: |
| Supplier3 YN5: |
| Distributor4 YN5: |
| Broker5 YN5: |
| Tier First Second Third etc5: |
| LSBE YN5: |
| work intended to be self performed5: |
| If not firsttier name of business with whom listed business is contracted5: |
| Dollar value of listed business contract5: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only5: |
| Manufacturer YN6: |
| Supplier3 YN6: |
| Distributor4 YN6: |
| Broker5 YN6: |
| Tier First Second Third etc6: |
| LSBE YN6: |
| work intended to be self performed6: |
| If not firsttier name of business with whom listed business is contracted6: |
| Dollar value of listed business contract6: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only6: |
| Manufacturer YN7: |
| Supplier3 YN7: |
| Distributor4 YN7: |
| Broker5 YN7: |
| Tier First Second Third etc7: |
| LSBE YN7: |
| work intended to be self performed7: |
| If not firsttier name of business with whom listed business is contracted7: |
| Dollar value of listed business contract7: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only7: |
| Dollar value of listed business contractTotal: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission onlyTotal: |
| 2_2: |
| Printed Name and Title_2: |
| Manufacture r YNY: |
| Supplier2 YNY: |
| Distributor3 YNY: |
| Broker4 YNY: |
| LSBE YNY: |
| Directly contracting through your firm or at a lower tier DirectlowerY: |
| If not firsttier name of business with whom listed business is contractedY: |
| Dollar value of listed business contract5Y: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission onlyY: |
| Manufacture r YN1: |
| Supplier2 YN1: |
| Distributor3 YN1: |
| Broker4 YN1: |
| LSBE YN1_2: |
| Directly contracting through your firm or at a lower tier Directlower1: |
| If not firsttier name of business with whom listed business is contracted1_2: |
| Dollar value of listed business contract51: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only1_2: |
| NAME OF SBE FROM FORM 12: |
| Y2: |
| Manufacture r YN2: |
| Supplier2 YN2: |
| Distributor3 YN2: |
| Broker4 YN2: |
| LSBE YN2_2: |
| Directly contracting through your firm or at a lower tier Directlower2: |
| If not firsttier name of business with whom listed business is contracted2_2: |
| Dollar value of listed business contract52: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only2_2: |
| NAME OF SBE FROM FORM 13: |
| Y3: |
| Manufacture r YN3: |
| Supplier2 YN3: |
| Distributor3 YN3: |
| Broker4 YN3: |
| LSBE YN3_2: |
| Directly contracting through your firm or at a lower tier Directlower3: |
| If not firsttier name of business with whom listed business is contracted3_2: |
| Dollar value of listed business contract53: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only3_2: |
| NAME OF SBE FROM FORM 14: |
| Y4: |
| Manufacture r YN4: |
| Supplier2 YN4: |
| Distributor3 YN4: |
| Broker4 YN4: |
| LSBE YN4_2: |
| Directly contracting through your firm or at a lower tier Directlower4: |
| If not firsttier name of business with whom listed business is contracted4_2: |
| Dollar value of listed business contract54: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only4_2: |
| NAME OF SBE FROM FORM 15: |
| Y5: |
| Manufacture r YN5: |
| Supplier2 YN5: |
| Distributor3 YN5: |
| Broker4 YN5: |
| LSBE YN5_2: |
| Directly contracting through your firm or at a lower tier Directlower5: |
| If not firsttier name of business with whom listed business is contracted5_2: |
| Dollar value of listed business contract55: |
| SBE Credit 6 Suppliers take 60 of price Distributors take 40 of price Brokers fees commission only5_2: |
| Subcontractor Bid Price: |
| BusinessName11: |
| 1_2: |
| 1_223: |
| Y1: |
| NAME OF SBE FROM FORM 11: |
| NAME OF SBE FROM FORM 111: |
| Y111: |
| Business Data Sheet also fulfills the requirements of the California Subletting and Subcontracting Fair Practices Act: |
| IFBRFPRFIQ Number 1: |
| IFBRFPRFIQ Number 2: |
| ProposalBid Due Date: |
| Total ProposalBid Price: |
| Your Firm: |
| SBE YNYour Firm: |
| Manufacturer YNYour Firm: |
| Supplier 1 YNYour Firm: |
| Broker 2 YNYour Firm: |
| ProposalBid Price Breakdown Your Firm: |
| SBE Credit if supplier take 60 of price if broker fess and commission onlyYour Firm: |
| 1: |
| SBE YN1: |
| Manufacturer YN1: |
| Supplier 1 YN1: |
| Broker 2 YN1: |
| ProposalBid Price Breakdown 1: |
| SBE Credit if supplier take 60 of price if broker fess and commission only1: |
| 2: |
| SBE YN2: |
| Manufacturer YN2: |
| Supplier 1 YN2: |
| Broker 2 YN2: |
| ProposalBid Price Breakdown 2: |
| SBE Credit if supplier take 60 of price if broker fess and commission only2: |
| 3: |
| SBE YN3: |
| Manufacturer YN3: |
| Supplier 1 YN3: |
| Broker 2 YN3: |
| ProposalBid Price Breakdown 3: |
| SBE Credit if supplier take 60 of price if broker fess and commission only3: |
| 4: |
| SBE YN4: |
| Manufacturer YN4: |
| Supplier 1 YN4: |
| Broker 2 YN4: |
| ProposalBid Price Breakdown 4: |
| SBE Credit if supplier take 60 of price if broker fess and commission only4: |
| 5: |
| SBE YN5: |
| Manufacturer YN5: |
| Supplier 1 YN5: |
| Broker 2 YN5: |
| ProposalBid Price Breakdown 5: |
| SBE Credit if supplier take 60 of price if broker fess and commission only5: |
| 6: |
| SBE YN6: |
| Manufacturer YN6: |
| Supplier 1 YN6: |
| Broker 2 YN6: |
| ProposalBid Price Breakdown 6: |
| SBE Credit if supplier take 60 of price if broker fess and commission only6: |
| 7: |
| SBE YN7: |
| Manufacturer YN7: |
| Supplier 1 YN7: |
| Broker 2 YN7: |
| ProposalBid Price Breakdown 7: |
| SBE Credit if supplier take 60 of price if broker fess and commission only7: |
| 8: |
| SBE YN8: |
| Manufacturer YN8: |
| Supplier 1 YN8: |
| Broker 2 YN8: |
| ProposalBid Price Breakdown 8: |
| SBE Credit if supplier take 60 of price if broker fess and commission only8: |
| 9: |
| SBE YN9: |
| Manufacturer YN9: |
| Supplier 1 YN9: |
| Broker 2 YN9: |
| ProposalBid Price Breakdown 9: |
| SBE Credit if supplier take 60 of price if broker fess and commission only9: |
| 10: |
| SBE YN10: |
| Manufacturer YN10: |
| Supplier 1 YN10: |
| Broker 2 YN10: |
| ProposalBid Price Breakdown 10: |
| SBE Credit if supplier take 60 of price if broker fess and commission only10: |
| Text1: |
| Text2: |
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