FORM 2 - AFFIDAVIT.pdf

PDF 122 KB Posted

Attached to
Plumbing Vacuum System Repair and Maintenance Services
Solicitation number
OP143876
Issued by
California

About this file

This is an affidavit form required by Metro for prime contractors and proposers participating in competitive bidding processes. The form mandates completion of specific sections to document compliance with Small Business Enterprise (SBE) and Disabled Veteran Business Enterprise (DVBE) participation requirements. Bidders must declare whether they have met or exceeded Metro's established SBE and DVBE participation goals by completing either Part A or Part B, along with Part C regarding Local Small Business Enterprise (LSBE) preferences. Part A applies when bidders have achieved participation levels greater than or equal to the SBE/DVBE goals, requiring them to specify the percentages achieved for both SBE and DVBE participation. Part B applies when bidders have not met the SBE and DVBE goals and must document the actual percentages achieved; notably, good faith efforts are no longer accepted under this scenario, and bidders failing to meet the established goals are ineligible for contract award.

Part C addresses 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 requires execution by an authorized representative with specified information including the date, location, business name, authorized signature, printed name, title, IFB/RFP/RFIQ number, and project name. This form serves as a compliance and certification document essential to the bid evaluation process, ensuring that prime contractors meet mandatory diversity and local business participation requirements established by Metro for contract opportunities.

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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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