FORM 2 - DBE AFFIDAVIT.pdf
PDF 117 KB Posted
- Attached to
- Exhaust Tube Assembly
- Solicitation number
- SD143358
- 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 LACMTA contracts. The form requires prime contractors to declare their DBE participation status and submit the completed affidavit as part of their bid package. Contractors must complete either Part A (if they have met or exceeded the DBE goal) or Part B (if they have not achieved the goal), along with Part C containing authorized signature and business information. The form serves as certification of DBE participation efforts and commitment to meeting or documenting good faith efforts toward the established DBE participation targets.
Contractors who have not met the DBE goal are required to submit Good Faith Efforts (GFE) documentation by the bid due date or face being deemed non-responsive. The affidavit requires contractors to specify the DBE percentage achieved, provide business contact information, obtain authorized signatures, and document the execution date and location. This form is a mandatory compliance document for LACMTA procurement processes and represents a key component of the agency's commitment to including disadvantaged business enterprises in contract opportunities.
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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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