FORM 2 - DBE AFFIDAVIT.pdf
PDF 117 KB Posted
- Attached to
- CRANE & CRANE OPERATOR RENTAL SERVICE
- Solicitation number
- OP140719
- Issued by
- California
About this file
This is a Disadvantaged Business Enterprise (DBE) Affidavit form required by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for prime contractors submitting bids on state and local contract opportunities. The form must be completed by the prime contractor only and requires submission of either Part A or Part B in conjunction with Part C. The affidavit certifies the contractor's DBE participation status relative to LACMTA's established DBE goal for the specific contract.
Prime contractors must declare whether they have met or exceeded the DBE participation goal (Part A) or failed to meet the goal despite good faith efforts (Part B), and must indicate the percentage of DBE participation achieved. Contractors who did not meet the established DBE goal must submit Good Faith Efforts (GFE) documentation by the bid due date; failure to provide this documentation will result in the bid being deemed non-responsive. Part C requires the authorized representative of the business to execute the affidavit with their signature, printed name, title, phone number, and email address, along with the business name, address, execution date, city, and state. This certification mechanism ensures LACMTA can track and verify DBE participation compliance across its contracting activities.
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Text version
FORM 2 – DBE AFFIDAVIT
TO BE COMPLETED BY PRIME ONLY
Complete Parts A and C or Parts B and C Part A: Met or Exceeded Goal
HAS ACHIEVED THE DBE PARTICIPATION FOR THIS CONTRACT
The Offeror 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 DBE goal established by LACMTA for DBE participation.
The Offeror declares it achieved the following DBE percentage:
_____________________________________________________________ Percent ( ____ %)
Part B: Did Not Meet Goal
HAS NOT ACHIEVED THE DBE PARTICIPATION FOR THIS CONTRACT
The Offeror declares to the best of its knowledge, information and belief that while it made efforts to achieve the DBE goal, it DID NOT ACHIEVE the DBE goal established by LACMTA. Offeror must submit Good Faith Efforts (GFE) documentation by bid due date or Offeror will be deemed non-responsive for failure to submit GFE documents with bid.
The Offeror achieved the following DBE percentage:
_____________________________________________________________ Percent ( ____ %)
Part C: SIGNATURE
Executed on: _____________________, 20 ___, at, _____________________________, _________ (Date) (City) (State)
Business Name: ____________________________________________________________________
Business Address: __________________________________________________________________ (Street) (City) (State)
Authorized Signature: ________________________________________________________________
Printed Name: ___________________________________ Title: ______________________________
Phone: ______________________________ Email: _______________________________________
| HAS ACHIEVED THE DBE PARTICIPATION FOR THIS CONTRACT: Off |
| The Offeror declares it achieved the following DBE percentage: |
| Percent: |
| HAS NOT ACHIEVED THE DBE PARTICIPATION FOR THIS CONTRACT: Off |
| The Offeror achieved the following DBE percentage: |
| Percent_2: |
| Executed on: |
| at: |
| undefined_2: |
| Business Name: |
| Business Address: |
| Printed Name: |
| Title: |
| Phone: |
| Email: |
| Text4: |
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