FORM 2 - DBE AFFIDAVIT.pdf
PDF 117 KB Posted
- Attached to
- TRANSMISSION KITS (VOITH TO ALLISON)
- Solicitation number
- DR145475
- 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 bidding on state and local contract opportunities. The form requires prime offerors to declare their DBE participation status and achieve or exceed LACMTA's established DBE participation goal. Offerors must complete either Part A if they have met or exceeded the DBE goal, or Part B if they have not met the goal, followed by Part C containing signature and business information sections. The form requires offerors to specify the percentage of DBE participation achieved and execute the affidavit with authorized signature, printed name, title, phone number, and email address.
Offerors who do not achieve the DBE participation goal established by LACMTA must submit Good Faith Efforts (GFE) documentation by the bid due date or risk being deemed non-responsive. The affidavit serves as a compliance mechanism to ensure that prime contractors make documented efforts to include disadvantaged business enterprises in contract performance and demonstrates commitment to LACMTA's diversity and inclusion objectives in procurement 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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