ISBE Form - RFP Appendix B - Modified Version.pdf
PDF 47 KB Posted
- Solicitation number
- QLV27007040
- Issued by
- Providence County, Rhode Island
About this file
This is a Minority/Women/Disability Business Enterprise Participation Plan form issued by the State of Rhode Island Department of Administration in connection with the Fully Integrated Dual Eligible Special Needs Plan Program (FIDE-SNP) solicitation administered by the Executive Office of Health and Human Services. The form is designed to document commitments between prime contractors and MBE/WBE and/or Disability Business Enterprise subcontractors and suppliers, capturing detailed information about subcontracted work, materials to be supplied, and participation percentages. All MBE/WBE subcontractors and suppliers must be certified by the Office of Diversity, Equity and Opportunity MBE Compliance Office at the time of bid submission, while Disability Business Enterprises must be certified by the Governor's Commission on Disabilities. The form requires separate submissions for each subcontractor or supplier utilized on the solicitation.
The form establishes specific requirements for participation credit: MBE/WBE and Disability Business Enterprise subcontractors must self-perform 100 percent of their contracted work or subcontract exclusively to another Rhode Island certified MBE to receive credit. For material and supply expenditures, vendors may count 60 percent of costs from MBE suppliers certified as regular dealers and 100 percent from those certified as manufacturers. The completed form must be submitted at the time of bid and requires certification under penalty of perjury from both the prime contractor/vendor and the subcontractor/supplier, with signatures, titles, and dates required from authorized representatives of each party.
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Text version
1 | P a g e
STATE OF RHODE ISLAND
DEPARTMENT OF ADMINISTRATION
ONE CAPITOL HILL
PROVIDENCE, RHODE ISLAND 02908
MBE, WBE, and/or DISABILITY BUSINESS ENTERPRISE PARTICIPATION PLAN
Bidder's Name:
Bidder's Address:
Point of Contact:
Telephone:
Email:
Solicitation No.:
Project Name:
This form is intended to capture commitments between the prime contractor/vendor and MBE/WBE and/or Disability
Business Enterprise subcontractors and suppliers, including a description of the work to be performed and the percentage of the work as submitted to the prime contractor/vendor. Please note that all MBE/WBE subcontractors/suppliers must be certified by the Office of Diversity, Equity and Opportunity MBE Compliance Office and all Disability Business Enterprises must be certified by the Governor's Commission on Disabilities at time of bid, and that MBE/WBE and Disability Business
Enterprise subcontractors must self-perform 100% of the work or subcontract to another RI certified MBE in order to receive participation credit. Vendors may count 60% of expenditures for materials and supplies obtained from an MBE certified as a regular dealer/supplier, and 100% of such expenditures obtained from an MBE certified as a manufacturer. This form must be completed in its entirety and submitted at time of bid. Please complete separate forms for each MBE/WBE or
Disability Business Enterprise subcontractor/supplier to be utilized on the solicitation.
Name of Subcontractor/Supplier:
Type of RI Certification: □ MBE □ WBE □ Disability Business Enterprise
Address:
Point of Contact:
Telephone:
Email:
Detailed Description of Work To Be
Performed by Subcontractor or
Materials to be Supplied by Supplier:
ISBE Participation Rate %
Commitment for this Subcontractor
Anticipated Date of Performance:
I certify under penalty of perjury that the forgoing statements are true and correct.
Prime Contractor/Vendor Signature Title Date
Subcontractor/Supplier Signature Title Date
Modified M/W/Disability Business Enterprise Utilization Plan - RFPs - Rev. 11/8/2021
File details come from the government source that posted it. Updated .