FORM 2 - AFFIDAVIT.pdf
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- Solicitation number
- OP142160(2)
- Issued by
- California
About this file
This is a Form 2 Affidavit document required by the Los Angeles Metropolitan Transportation Authority (Metro) for prime contractors bidding on state and local contract opportunities. The form serves as a declaration of the bidder's or proposer's participation in Small Business Enterprise (SBE) and Disabled Veteran Business Enterprise (DVBE) programs, as well as Local Small Business Enterprise (LSBE) preference eligibility. Prime contractors must complete either Part A or Part B in conjunction with Part C, depending on whether they have met or exceeded Metro's established SBE and DVBE participation goals. The form requires submission of specific percentages for both SBE and DVBE participation, along with authorization signatures, business identification information, and the associated IFB/RFP/RFIQ number and project name.
Part A applies when bidders have achieved SBE and DVBE participation levels equal to or greater than Metro's established goals and must declare the specific percentages achieved. Part B applies when bidders have not met the goals, with the notation that Good Faith Efforts (GFE) is no longer accepted as a remedy and that bidders failing to meet SBE and DVBE goals are ineligible for award. Part C requires bidders to declare their LSBE preference eligibility status, either as a Metro-certified LSBE firm or as a non-certified firm subcontracting at least 30 percent of the contract value with eligible LSBE firms. The affidavit must be executed with the date, location, authorized signature, and printed name and title of the signatory.
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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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