FORM 2 - AFFIDAVIT.pdf
PDF 122 KB Posted
- Solicitation number
- DR144532
- Issued by
- California
About this file
This is an affidavit form required by Metro for prime contractors bidding on state and local contract opportunities. The form establishes compliance with Small Business Enterprise (SBE) and Disabled Veteran Business Enterprise (DVBE) participation requirements. Contractors must complete either Part A or Part B in conjunction with Part C. Part A applies when bidders have met or exceeded Metro's established SBE and DVBE participation goals and must document the specific percentages achieved for both categories. Part B applies when bidders have not achieved the required goals and declares that Good Faith Efforts alone are insufficient; contractors failing to meet SBE and DVBE goals are ineligible for award. Part C addresses Local Small Business Enterprise (LSBE) preference eligibility, requiring bidders to certify either that they are Metro-certified LSBE firms or that they subcontract at least 30 percent of contract value to eligible LSBE firms.
The affidavit must be executed by an authorized representative of the prime contractor and include the business name, signatory information, contract identification number, project name, execution date, and location. No specific pricing terms, contract amounts, or project timelines are detailed in this form, as it serves solely as a certification document for subcontracting and small business participation goals established by Metro for individual solicitations referenced by their IFB, RFP, or RFIQ number.
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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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