M140-00-45-39-EDGE-Affidavit.pdf
PDF 27 KB Posted
- Attached to
- FAC MGMT 25-25046 Shipley Carpet Replacement State and local contract opportunity
- Solicitation number
- SRC0000030618
- Issued by
- Franklin County, Ohio
About this file
The document is an EDGE (Encouraging Diversity, Growth, and Equity) Affidavit from the State of Ohio's Standard Requirements for Public Facility Construction, specifically Document 00 45 39, dated 2014 Edition (2016-MAR). This form is a Certified Statement of Intent to Contract and Perform, designed for bidders or proposers to document their intention to work with an EDGE-certified business on a public construction project. The form allows contractors to specify the type of contract (Multi-Prime, General, CM at Risk, or Design-Build) and the role of the EDGE-certified business (Subcontractor, Material Supplier, Professional Services, or Goods & Services).
The document is structured to capture critical information about both the primary bidder and the EDGE-certified business, including company names, addresses, certification numbers, and contact details. The key purpose is to formalize the intent to contract, with both parties signing to certify their commitment to working together on a specified portion of the project. The form requires a detailed description of materials, labor, services, or supplies to be provided, along with the estimated cost. If the bidder is not awarded the contract, the statement becomes null and void, providing flexibility in the bidding process while encouraging diversity in public facility construction contracts.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 25-25046 Shipley Carpet Replacement project info.pdf | ||
| 25-25046 Shipley Carpet Replacement Bid Documents Relist.pdf | ||
| 25-25046 Shipley Carpet Replacement- Bid Solicitation.pdf | ||
| M140-00-43-13-Bid-Security-Form.pdf | ||
| PW Determination Cover Letter, PW Rates.pdf |
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Text version
Document 00 45 39 - EDGE Affidavit State of Ohio Standard Requirements for Public Facility Construction
M140-00 45 39 2014 Edition (2016-MAR) Page 1 of 1
EDGE PARTICIPATION
Certified Statement of Intent to Contract and Perform
Bidder or Proposer: Submit one fully completed form for each EDGE-certified Business
Project: _________________________________________________
Project Name: _________________________________________________
A. Bidder or Proposer’s Company Name:
Mark all that apply:
_ _ Multi-Prime Contract __ General Contract __ CM at Risk Contract __ Design-Build Contract
B. EDGE-certified Business information (for contract at ANY tier)
Mark all that apply:
__ Subcontractor __ Material Supplier __ Professional Services __ Goods & Services
EDGE Business Name:
EDGE Business Address:
EDGE Certification Number: E-mail:
Contact Person: Phone:
Insert detailed description of materials, labor, services, supplies, etc. (may use industry codes – continue on separate page):
C. Certification of Intent
By signing below, the Bidder or Proposer certifies that it intends to contract with the EDGE-certified Business for the portion of the contract described above related to its Contract for this Project and for the estimated cost shown below. By signing below, the EDGE-certified Business certifies that it intends to contract with the Bidder or Proposer and intends to provide the portion of the contract described above related to the Contract for this Project for the estimated cost of:
and /100 dollars ( $ ).
In the event the named Bidder or Proposer is NOT awarded a Contract, this Statement shall be null and void.
EDGE-certified Business
Authorized Signature
Name and Title
Date Signed
Bidder or Proposer
Authorized Signature
Name and Title
Date Signed
END OF DOCUMENT
| Project Name: |
| EDGE Business Name: |
| EDGE Business Address 1: |
| EDGE Business Address 2: |
| EDGE Certification Number: |
| Email: |
| Contact Person: |
| Phone: |
| Name and Title: |
| Date Signed: |
| Name and Title_2: |
| Date Signed_2: |
| cents: |
| dollars in words: |
| amount in numerals: |
| Insert detailed description of materials labor services supplies etc 1: |
| Insert detailed description of materials labor services supplies etc 2: |
| Insert detailed description of materials labor services supplies etc 3: |
| Project Number: |
| Check Box 8: Off |
| Check Box 7: Off |
| Check Box 6: Off |
| Check Box 5: Off |
| Check Box 1: Off |
| Check Box 2: Off |
| Check Box 3: Off |
| Check Box 4: Off |
| Bidder or Proposer Company Name: |
File details come from the government source that posted it. Updated .