FORM 2 - SBE AFFIDAVIT.pdf

PDF 104 KB Posted

Attached to
Disadvantage and Small Business Enterprise Certification Services
Solicitation number
PS143910
Issued by
California

About this file

This is a Small Business Enterprise (SBE) Commercially Useful Function Affidavit form required as part of a state and local contract opportunity submission process. The form serves as a declaration by the prime bidder or proposer confirming compliance with SBE participation requirements. The primary requirement stipulated in the document is that the bidder must perform at least 30 percent of the contract work with its own workforce. An SBE is defined as performing a commercially useful function when it is responsible for execution of the work and actively performs, manages, and supervises the involved responsibilities. The form explicitly prohibits SBEs from serving merely as pass-through entities designed to create the appearance of SBE participation without substantive involvement.

The affidavit portion requires the authorized principal of the business—such as a Director, Officer, or General Partner—to execute the form and certify the accuracy and completeness of all submitted information. Required signatures and supporting documentation include the business name, address, authorized signature, printed name, title, phone number, and email address, along with the execution date, city, and state. The document references additional SBE commitment forms that must accompany this affidavit, including Form 1 (SBE Subcontractors & Suppliers), Form 3 (Business Data Sheet), and Form 4 (SBE Affirmation), as well as supporting information attachments from SBE subcontractors.

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Other files

File Type Posted
EXHIBIT 5 - BIDDERS LIST FORM.pdf PDF
FORM 3 - SBE BUSINESS DATA SHEET.pdf PDF
EXHIBIT 6 - PROPOSAL LETTER.pdf PDF
EXHIBIT 11 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655.pdf PDF
EXHIBIT A - SCOPE OF SERVICES.pdf PDF
EXHIBIT D - DEOD CONTRACT COMPLIANCE MANUAL (SET-ASIDE).pdf PDF
EXHIBIT 10 - GENERAL CERTIFICATIONS.pdf PDF
FORM 4 - SBE AFFIRMATION.pdf PDF
FORM 6 - SBE REGULAR DEALER DIST AFFIRMATION.pdf PDF
EXHIBIT 7 - LIST OF CURRENT CONTRACTS - BACKLOG.pdf PDF
EXHIBIT 14 - NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY PROPOSER (RESERVED).pdf PDF
EXHIBIT 8 - LIST OF COMPLETED CONTRACTS - LAST FIVE (5) YEARS.pdf PDF
EXHIBIT I - 49 CRF PART 20 (RESERVED).pdf PDF
EXHIBIT G - APPROVED SUBCONTRACTORS AND SUPPLIERS.pdf PDF
PS143910.pdf PDF
FORM 1 - SBE PROPOSED SUBCONTRACTORS & SUPPLIERS.pdf PDF
SUBCONTRACTOR LIST.pdf PDF
EXHIBIT 2 - SCHEDULE OF QUANTITIES & PRICES.xlsx XLSX spreadsheet
EXHIBIT 9 - ETHICS DECLARATION.pdf PDF
EXHIBIT 12 - CERT OF COMPLIANCE WITH FED LOBBYING REQ (49 CFR PART 20).pdf PDF
EXHIBIT B - PRICING AGREEMENT.pdf PDF
EXHIBIT E-1 - PAYMENT CERTIFICATION (CONTINUOUS).pdf PDF
EXHIBIT J - 29 CFR 5.5 AND APPLICABLE FEDERAL PREVAILING WAGE CLASSIFICATIONS (RESERVED).pdf PDF
EXHIBIT E-2 - PAYMENT CERTIFICATION (FINAL).pdf PDF
EXHIBIT H - MISCELLANEOUS (RESERVED).pdf PDF
EXHIBIT C - WORK-COMPLETION_DELIVERABLE SCHEDULE (RESERVED).pdf PDF
EXHIBIT 3 - EVALUATION CRITERIA.pdf PDF
FORM 5 - SBE BIDDERS LIST.pdf PDF
EXHIBIT 4 - LIST OF CERTIFIED FIRMS (RESERVED).pdf PDF
EXHIBIT 13 - CERT OF PROSPECTIVE CONTRACTOR AND LOWER TIER PARTICIPANT.pdf PDF
EXHIBIT F - RELEASE OF CLAIMS.pdf PDF
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FORM 2 - COMMERCIALLY USEFUL FUNCTION AFFIDAVIT

TO BE COMPLETED BY PRIME ONLY

PART A: AFFIDAVIT

An SBE performs a commercially useful function (CUF) when it is responsible for at least execution of the work of the contract and is carrying out its responsibilities by actually performing, managing, and supervising the work involve. An SBE does not perform a CUF if its role is limited to that of an extra participant in a transaction, contract, or project through which funds are passed in order to obtain the appearance of SBE participation.

The Bidder/Proposer acknowledges that it will perform at least 30% of the work for during the performance this contract with its own workforce in compliance with the CUF requirements.

The Bidder/Proposer declares to perform the following percentage of work with its own workforce:

_____________________________________________________________ Percent ( ____ %)

PART B: SIGNATURE

The undersigned Director, Officer, General Partner, or similarly situated Principal of the business declares he/she is informed and believe, and thereon allege, that to the best of their knowledge, information and belief, the information set forth on this page of this document and any attachments, is current, complete and accurate.

Executed on: _____________________, 20 ___, at, _____________________________, _________ (Date) (City) (State)

Business Name: ____________________________________________________________________

Business Address: __________________________________________________________________ (Street) (City) (State)

Authorized Signature: ________________________________________________________________

Printed Name: ___________________________________ Title: ______________________________

Phone: ______________________________ Email: _______________________________________

TABLE 1 - SBE COMMITMENT FORMS
SUBCONTRACTOR LISTING FORM FOR IFB ONLY
FORM 1 - SBE SUBCONTRACTORS & SUPPLIERS
ATTACHMENT A TO FORM 1: SUPPORTING INFORMATION FROM SBE SUBCONTRACTOR
ATTACHMENT A TO FORM 1: SUPPORTING INFORMATION FROM SBE SUBCONTRACTOR
FORM 2 - COMMERCIALLY USEFUL FUNCTION AFFIDAVIT
FORM 3 - BUSINESS DATA SHEET Page 1 of 2
FORM 4 – SBE AFFIRMATION
The BidderProposer declares to perform the following percentage of work with its own workforce:
Percent:
at:
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Business Name:
Business Address:
Printed Name:
Title:
Phone:
Email:
Executed on:

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