FORM_-_3_Personal-Professional_Contract_-_Monthly_Sub-consultant_Payment_and_Utilization_Report_.pdf
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- Solicitation number
- 26-061
- Issued by
- Washington County, Barlow City, Oregon
About this file
This is a Monthly Subcontractor Payment and Utilization Report form designed for professional service contracts, specifically for tracking subcontractor payments and certifications on state and local projects. The form is used by prime consultants to document monthly utilization of subcontractors on contract projects, requiring submission for each fiscal year and month of work. The related contract opportunity involves the City of Beaverton Municipal Court's Request for Proposal for Traffic School Program Provider and Related Services, with proposals due by May 7, 2026, at 5:00 p.m., presentations scheduled for May 18, 2026, and contract award anticipated by June 16, 2026. The selected vendor(s) will deliver accessible Traffic Safety classes for approximately 5,000 defendants annually, with expected growth due to expanded photo enforcement. Classes must be offered online and in-person in English and Spanish, available nights and weekends, compliant with WCAG 2.1 Level AA accessibility standards, and integrated with the Court's systems via REST API. The contract will commence August 1, 2026, with an initial five-year term through July 31, 2031, and potential renewal for additional one-year terms at the City's option.
The report form requires documentation of all subcontractors listed in bid plans and their certifications, including COBID-certified firms (Emerging Small Business, Minority-Owned Business, Women-Owned Business, Service-Disabled Veteran-Owned Business, Disadvantaged Business Enterprise, and Auxiliary Community-based Disadvantaged Business Enterprise). Proposers must demonstrate good faith efforts in utilizing COBID-certified subcontractors with an aspirational goal of 15 percent participation. Traffic Safety classes are priced on a firm fixed-cost-per-student basis, capped at $45 to $50 per course, with vendors paying the City $5 per certificate for API processing; no minimum number of defendants is guaranteed. Vendors must maintain commercial general liability insurance of $2,000,000 to $5,000,000 per occurrence, workers' compensation insurance, automobile liability insurance, and professional liability insurance. All data and certificates must be retained for a minimum of five years, and technical support must be provided Monday through Friday from 8:00 a.m. to 5:00 p.m., with dedicated representatives responding to Court inquiries within three business days. The City intends to select at least two vendors and retains the right to terminate for convenience with thirty days' notice or for cause immediately.
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Text version
PROGRAM: FORM 3
PROFESSIONAL SERVICE - MONTHLY SUBCONTRACTOR PAYMENT AND UTILIZATION REPORT
Date Submitted: ______________________________________ Report for FY: __________________ Month: ____________
Project Name: ________________________________________________________________________ Contract Number: _________________________
Prime Consultant: _____________________________________________________________________ Total Contract Amt.: ______________________
Progress Report No.: __________________________________________________________________ Final Progress Report? ☐ Yes ☐ No
* Before replacing, substituting, or adding any subcontractor, Contractor must receive written authorization from the Purchasing Agent.
** ESB: Emerging Small Business; MBE: Minority-owned Business; WBE: Women-Owned Business; SDV: Service-Disabled Veteran-Owned; DBE & ACDBE: Disadvantaged Business Enterprise
BY SIGNING BELOW, I HEREBY CERTIFY THAT THE BUSINESS HAS UTILIZED THE ABOVE LISTED FIRMS IN THE AMOUNTS REPRESENTED ABOVE AND THAT
THE INFORMATION CONTAINED HEREIN IS COMPLETE AND ACCURATE.
Authorized Signature of Contractor: __________________________________________________________ Date: __________________
Printed Name of Signatory: _________________________________________________________________
NAME OF SUBCONTRACTOR*
(INCLUDE ALL LISTED ON BID PLAN)
COBID
Certified
TYPE OF CERTIFICATION**
(Check all that apply) ORIGINAL AWARD
AMOUNT
AMENDED AWARD
AMOUNT
(IF APPLICABLE)
TOTAL AMOUNT
PAID
THIS PAY PERIOD ONLY
MBE WBE SDV ESB
DBE &
ACDBE
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
| Date Submitted: |
| Report for FY: |
| Month: |
| Project Name: |
| Contract Number: |
| Prime Consultant: |
| Total Contract Amt: |
| Progress Report No: |
| Final Progress Report: Off |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow1: |
| undefined: Off |
| MBEYes No: |
| WBEYes No: |
| SDVYes No: |
| ESBYes No: |
| DBE ACDBEYes No: |
| ORIGINAL AWARD AMOUNTYes No: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow2: |
| undefined_2: Off |
| MBEYes No_2: |
| WBEYes No_2: |
| SDVYes No_2: |
| ESBYes No_2: |
| DBE ACDBEYes No_2: |
| ORIGINAL AWARD AMOUNTYes No_2: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_2: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_2: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow3: |
| undefined_3: Off |
| MBEYes No_3: |
| WBEYes No_3: |
| SDVYes No_3: |
| ESBYes No_3: |
| DBE ACDBEYes No_3: |
| ORIGINAL AWARD AMOUNTYes No_3: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_3: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_3: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow4: |
| undefined_4: Off |
| MBEYes No_4: |
| WBEYes No_4: |
| SDVYes No_4: |
| ESBYes No_4: |
| DBE ACDBEYes No_4: |
| ORIGINAL AWARD AMOUNTYes No_4: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_4: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_4: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow5: |
| undefined_5: Off |
| MBEYes No_5: |
| WBEYes No_5: |
| SDVYes No_5: |
| ESBYes No_5: |
| DBE ACDBEYes No_5: |
| ORIGINAL AWARD AMOUNTYes No_5: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_5: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_5: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow6: |
| undefined_6: Off |
| MBEYes No_6: |
| WBEYes No_6: |
| SDVYes No_6: |
| ESBYes No_6: |
| DBE ACDBEYes No_6: |
| ORIGINAL AWARD AMOUNTYes No_6: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_6: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_6: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow7: |
| undefined_7: Off |
| MBEYes No_7: |
| WBEYes No_7: |
| SDVYes No_7: |
| ESBYes No_7: |
| DBE ACDBEYes No_7: |
| ORIGINAL AWARD AMOUNTYes No_7: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_7: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_7: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow8: |
| undefined_8: Off |
| MBEYes No_8: |
| WBEYes No_8: |
| SDVYes No_8: |
| ESBYes No_8: |
| DBE ACDBEYes No_8: |
| ORIGINAL AWARD AMOUNTYes No_8: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_8: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_8: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow9: |
| undefined_9: Off |
| MBEYes No_9: |
| WBEYes No_9: |
| SDVYes No_9: |
| ESBYes No_9: |
| DBE ACDBEYes No_9: |
| ORIGINAL AWARD AMOUNTYes No_9: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_9: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_9: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow10: |
| undefined_10: Off |
| MBEYes No_10: |
| WBEYes No_10: |
| SDVYes No_10: |
| ESBYes No_10: |
| DBE ACDBEYes No_10: |
| ORIGINAL AWARD AMOUNTYes No_10: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_10: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_10: |
| NAME OF SUBCONTRACTOR INCLUDE ALL LISTED ON BID PLANRow11: |
| undefined_11: Off |
| MBEYes No_11: |
| WBEYes No_11: |
| SDVYes No_11: |
| ESBYes No_11: |
| DBE ACDBEYes No_11: |
| ORIGINAL AWARD AMOUNTYes No_11: |
| AMENDED AWARD AMOUNT IF APPLICABLEYes No_11: |
| TOTAL AMOUNT PAID THIS PAY PERIOD ONLYYes No_11: |
| Date: |
| Printed Name of Signatory: |
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