FORM 2 - AFFIDAVIT.pdf

PDF 122 KB Posted

Attached to
Corrosion Control System Upgrades
Solicitation number
OP138382(2)
Issued by
California

About this file

This is an affidavit form required by Metro for prime contractors and proposers participating in a state and local contract opportunity. The form establishes compliance with Small Business Enterprise (SBE) and Disabled Veteran Business Enterprise (DVBE) participation requirements. Bidders must complete either Part A or Part B along with Part C. Part A applies when bidders have met or exceeded Metro's established SBE and DVBE participation goals and must declare the specific percentages achieved for each category. Part B applies when bidders have not met the SBE and DVBE goals despite making good faith efforts; notably, good faith efforts are no longer accepted as an alternative, and bidders failing to meet the stated goals are ineligible for award. The form requires completion of an IFB, RFP, or RFIQ number and project name along with execution date and location.

Part C addresses Local Small Business Enterprise (LSBE) preference eligibility, allowing bidders to declare either that they are Metro-certified LSBE firms or that they subcontract at least 30 percent of the contract value with eligible LSBE firms. The affidavit must be signed by an authorized representative of the bidding entity and include the business name, authorized signature, printed name, and title. This document serves as a formal declaration ensuring compliance with Metro's diversity and inclusion program requirements for contract participation.

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Text version

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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