FORM 2 - AFFIDAVIT.pdf

122 KB Posted

Attached to
Underground Storage Tank & Aboveground Storage Tank Services
Solicitation number
OP140983
Issued by
California

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This is an Affidavit form for prime contractors and proposers participating in Metro contract opportunities. The form requires bidders and proposers to declare their Small Business Enterprise (SBE) and Disadvantaged Veterans Business Enterprise (DVBE) participation levels. Bidders must complete either Part A or Part B along with Part C. Part A is used when a bidder has met or exceeded the SBE and DVBE goals established by Metro, requiring declaration of the achieved SBE percentage and DVBE percentage. Part B is used when a bidder has not met the established SBE and DVBE goals, with the critical stipulation that Good Faith Efforts are no longer accepted as justification, and bidders failing to meet the goals are ineligible for award. The form requires completion of IFB/RFP/RFIQ number, project name, date, and location of execution.

Part C addresses Local Small Business Enterprise (LSBE) Preference eligibility, requiring the proposer to declare whether it is a Metro-certified LSBE firm or, alternatively, whether it subcontracts at least 30 percent of the contract value with eligible LSBE firms. Part D requires authorized signature, printed name, title, and business information from the responsible bidder representative. The form structure indicates that Metro enforces mandatory SBE and DVBE participation thresholds with no exceptions for insufficient participation levels, making this affidavit a compliance requirement for contract award eligibility.

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EXHIBIT D - DEOD CONTRACT COMPLIANCE MANUAL (Non-Fed).pdf PDF
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FORM 2 - AFFIDAVIT

TO BE COMPLETED BY PRIME ONLY

Complete Parts A and C or Parts B and C

PART A: SBE and DVBE – MET OR EXCEEDED GOAL

HAS LISTED SBE and DVBE PARTICIPATION FOR THIS CONTRACT

The Bidder/Proposer declares to the best of its knowledge, information and belief that by its efforts, it ACHIEVED a level of participation greater than or equal to the SBE/DVBE goal established by Metro for SBE/DVBE participation.

The Bidder/Proposer declares it achieved the following SBE percentage:

_____________________________________________________________ Percent ( ____ %)

The Bidder/Proposer declares it achieved the following DVBE percentage:

_____________________________________________________________ Percent ( ____ %)

PART B: SBE and DVBE – DID NOT MEET GOAL

HAS NOT LISTED SBE and DVBE PARTICIPATION FOR THIS CONTRACT The Bidder/Proposer declares to the best of its knowledge, information and belief that while it made efforts to achieve the SBE and DVBE goal, it DID NOT ACHIEVE the SBE and DVBE goal established by Metro. Good Faith Efforts (GFE) is no longer accepted if the SBE and DVBE goals are not met. Bidder/Proposers that do not meet the SBE and DVBE goals will not be eligible for award.

The Bidder/Proposer achieved the following SBE percentage:

_____________________________________________________________ Percent ( ____ %)

The Of Bidder/Proposer achieved the following DVBE percentage:

_____________________________________________________________ Percent ( ____ %)

PART C: LOCAL SMALL BUSINESS ENTERPRISE (LSBE) PREFERENCE

The Proposer declares to the best of its knowledge, information and belief meets the eligibility criteria for a LSBE preference, as defined by Metro program guidelines, as stated in the Letter of Invitation Supplement, Section B, “Local Small Business Enterprise (LSBE) Preference. (Check which applies)

Bidder/Proposer itself is a Metro certified LSBE firm

Bidder/Proposer is not a Metro certified LSBE but subcontracts at least 30% of the contract value with eligible LSBE firms.

PART D: SIGNATURE

Executed on: _____________________, 20 ___, at, _____________________________, _________ (Date) (City) (State)

Business Name: ____________________________________________________________________ (Street) (City) (State)

Authorized Signature: ________________________________________________________________

Printed Name: ___________________________________ Title: ______________________________

IFB/RFP/RFIQ Number: _________________ Project Name: _________________________________

PART A SBE and DVBE MET OR EXCEEDED GOAL:
HAS LISTED SBE and DVBE PARTICIPATION FOR THIS CONTRACT: Off
The BidderProposer declares it achieved the following SBE percentage:
Percent:
The BidderProposer declares it achieved the following DVBE percentage:
Percent_2:
HAS NOT LISTED SBE and DVBE PARTICIPATION FOR THIS CONTRACT: Off
The BidderProposer achieved the following SBE percentage:
Percent_3:
The Of BidderProposer achieved the following DVBE percentage:
Percent_4:
BidderProposer itself is a Metro certified LSBE firm: Off
BidderProposer is not a Metro certified LSBE but subcontracts at least 30 of the contract value: Off
Executed on:
at:
undefined_4:
Business Name_2:
Printed Name:
Title:
IFBRFPRFIQ Number_3:
Project Name:
Text8:

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