MWBE_Participation_Commitment_Form.docx

MINORITY AND WOMEN BUSINESS ENTERPRISE (MWBE) PARTICIPATION COMMITMENT FORM

RESPONDENT:

SOLICITATION NUMBER: DATE:

All Respondents, including Minority Business Enterprise (MBE) firms and Women Business Enterprise (WBE) firms, should complete and submit this MWBE Participation Commitment Form with their responses. Through submission of its response, Respondent certifies, acknowledges, and agrees that Respondent will commit to utilize MBE and WBE firms in compliance with the participation levels specified herein, and that those participation levels are accurate and true.

For the purposes of MWBE participation in Leon County Government, City of Tallahassee, and Blueprint Intergovernmental Agency projects, certified MBE and WBE firms are certified by the Office of Economic Vitality Minority, Women, and Small Business Enterprise (MWSBE) Division.

The project specific goals for this solicitation are located under Minority, Women, Small Business (MWSBE) Enterprise, MWSBE Overview of this solicitation.

SECTION 1 – MWBE Participation Commitment

Complete the following table by inserting an “X” to select the line that indicates the level of MWBE commitment that the Respondent will utilize in projects assigned from any contracts resulting from this solicitation.

MWBE Scoring

**These points are in addition to the MWBE scores listed above

SECTION 2 – Anticipated MWBE Vendor Utilization

Complete the following table to identify the certified MBE and WBE firm(s) that the Respondent anticipates/intends to utilize in projects assigned from any contracts resulting from this solicitation. Additional pages may be used as necessary.

SECTION 3 – Mentor-Protégé; Joint Venture, Partnership, and Association, and Apprenticeship or Externship

· Respondent is participating in a Mentor-Protégé relationship in accordance with the MWSBE Policy with one or more firms identified in the Respondent and Team Summary Form. A Mentor-Protégé Development Plan is attached to this form.

· Respondent is participating in a Joint Venture, Partnership, or Association in accordance with the MWSBE Policy with one of the firms identified in the Respondent and Team Summary Form. A Joint Venture, Partnership, and Association Affidavit is attached to this form.

· Respondent or one or more of the firms identified in the Respondent and Team Summary Form are participating in an Apprenticeship or Externship Program in accordance with the MWSBE Policy. An Apprenticeship or Externship Affidavit is attached to this form.

Respondent will include documentation to support all participation identified above as an attachment to this Form. Necessary forms are available in the solicitation under Attachments.

ACKNOWLEDGEMENT

I hereby certify, as Respondent to this Solicitation, that the information provided herein is true and correct. I affirm that I have authority to bind Respondent to contractual agreements.

Respondent has communicated with the subcontractors and subconsultants identified herein, and those subcontractors and subconsultants understand that Respondent anticipates/intends to utilize them on assigned projects, if awarded. Respondent agrees that bad faith or dishonesty in the information provided on this MWBE Participation Commitment Form is a violation of MWSBE Policy Section VIII.G. If awarded, Respondent agrees to utilize MWBE firms, to endeavor to pay those firms to meet the project specific goals for this solicitation, to monitor the work of the firms, to provide subcontractor or subconsultant payment information to the MWSBE Division, and to abide by the MWSBE Policy.

Name of Respondent

Title of Signatory

Signature

Date

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