MPA MBE Participation Acknowledgment.pdf
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- Solicitation number
- RFQM27006929
- Issued by
- Rhode Island
About this file
This is an MBE Participation Acknowledgment form issued by the Division of Equity, Diversity and Inclusion Minority Business Enterprise Compliance Office under the State of Rhode Island. The form applies to MPA 564 FY27 Window Blinds/Shades and Accessories procurement, which requires contractors to furnish and install window treatments, blinds, shades, and related accessories throughout Rhode Island. Prime contractors responding to this solicitation must complete and sign this acknowledgment form prior to contract award, confirming their understanding of and commitment to minority and women business enterprise participation requirements.
Rhode Island General Laws 37-14.1 mandates that all state-funded and state-directed public construction programs, projects, and purchases include Minority Business Enterprises (MBE) and Women Business Enterprises (WBE), with a minimum of 15 percent of the total dollar value awarded to certified MBE/WBE businesses. By signing this acknowledgment, contractors confirm they understand these requirements and agree to submit executed subcontractor agreements to the MBE Compliance Office, provide monthly reports documenting payments to MBE subcontractors, immediately notify the office of any changes to vendors or subcontractors, and comply with all conditions or face potential non-compliance determinations and sanctions. Contractors must also indicate their certification status as MBE, WBE, Veteran-Owned Business Enterprise (VBE), or not applicable.
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Division of Equity, Diversity and Inclusion Minority Business Enterprise Compliance Office
One Capitol Hill, Providence, R.I. 02908-5850
(401) 574-8670 - mbe.compliance@doa.ri.gov - RI Relay 711
MPA PRE-AUTHORIZATION MBE PARTICIPATION ACKNOWLEDGMENT
MPA # and Title: ________________________________________________________________________________
Prime Contractor: _________________________ Authorized Contact Person: _______________________________
Contractor Phone Number: ________________________ Contractor Email: _________________________________
Which of the following describes your business’ status in terms of Minority and/or Woman, and/or Veteran-Owned
Business Enterprise certification with the State of Rhode Island? MBE ____ WBE ____ VBE ____ or N/A _____
Rhode Island General Laws § 37-14.1 et al., requires Minority and Women Business Enterprises be included in all state funded and state directed public construction programs and projects and in state purchases of goods and services and shall be awarded a minimum of 15% of the dollar value of an entire procurement or project. By initialing the following sections and signing the bottom of this document in my capacity as the contractor or an authorized representative of the contractor, I hereby confirm that:
• I acknowledge the State’s requirements of including MBE/WBE certified businesses in all state funded and state directed public construction programs, projects and purchases.
Initials: _____
• I acknowledge that, if awarded the contract, the company must submit to the MBE Compliance Office (MBECO), copies of all executed agreements with the subcontractor(s) being utilized to achieve the participation goals.
Initials: _____
• I acknowledge that, if awarded the contract, the company must submit required reports and documents to the MBECO on a monthly basis verifying payments to the MBE subcontractors.
Initials: _____
• I acknowledge that, if awarded the contract, the company is required to immediately notify the MBECO of
ALL changes in the use of vendors, subcontractors, or suppliers used under this contract including ALL Change Orders.
Initials: _____
• I acknowledge that, if awarded the contract, any failure to comply with the conditions acknowledged above may result in a determination of Non-Compliance and may result in sanctions pursuant to R.I. Gen. Laws § 37-14.1 et al.
Initials: _____
I, as an authorized signatory for the prime contractor, do solemnly declare and affirm under the penalty of perjury that the contents of the foregoing Acknowledgment are true and correct to the best of my knowledge, information and belief.
Printed Name Signature Date mailto:mbe.compliance@doa.ri.gov
| MPA PRE-AUTHORIZATION MBE PARTICIPATION ACKNOWLEDGMENT |
| MPA # and Title: ________________________________________________________________________________ |
| MPA and Title: |
| Prime Contractor: |
| Authorized Contact Person: |
| Contractor Phone Number: |
| Contractor Email: |
| Business Enterprise certification with the State of Rhode Island MBE: |
| WBE: |
| VBE: |
| or NA: |
| Initials: |
| Initials_2: |
| Initials_3: |
| Initials_4: |
| Initials_5: |
| Printed Name: |
| Date: |
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