RFP 8240 ATTACH B MWBE.pdf

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Attached to
SPECIALITY PHARMACY PAYOR ACCESS
Solicitation number
RFP # 8240
Issued by
Washington

About this file

This is an Attachment B MWBE (Minority and Women's Business Enterprises) participation form for RFP No. 10266 issued by UW Medicine (University of Washington Medical Center) in Washington State. The form serves as a voluntary disclosure document for bidders responding to the Specialty Pharmacy Payor Access contract opportunity. Suppliers must complete the applicable sections based on their business classification and participation structure, including sections for direct MWBE certification, MWBE subcontract participation, no MWBE participation declaration, Federal Small Business certification, Small Business subcontract participation, or no Small Business participation. The form requires identification of participating firms, descriptions of their roles, dollar amounts and percentages of contract participation, and authorized representative signatures.

The submission of this form is mandatory for all bidders, though MWBE and Small Business participation goals are established as voluntary targets rather than mandatory requirements. No minimum participation levels are required, and proposals will not be rejected based on the level of MWBE or Small Business participation. Contractors selected for award must maintain records for three years documenting utilization of MWBEs and other businesses as subcontractors and suppliers, including all quotes and proposals received. The State of Washington encourages affirmative efforts to increase MWBE participation through advertising, provision of contract information, task breakdown, favorable delivery schedules, reduced bonding requirements, and engagement with minority community organizations. Federal Small Business Administration definitions and certifications apply when federal funds are involved, with the SBA Seattle office available for certification guidance at (206) 553-7310.

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Other files

File Type Posted
RFP 8240 ATTACH C Sustainability Questions.xlsx XLSX spreadsheet
RFP 8240 ATTACH D Bidders Questions.xlsx XLSX spreadsheet
RFP 8240 Part 2 Pharmacy Payor Access.docx DOCX document
RFP 8240 Part 1 Pharmacy Payor Access.docx DOCX document
RFP 8240 ATTACH A Proposal Response Cert.pdf PDF

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RFP No. 10266 Approved AGO 09.09.2018 UWMC Int. – 03.06.2020 Rev. 17 – 03.08.2025

ATTACHMENT B

This solicitation includes voluntary goals for MWBE and Small Business participation.

Complete this form and return it with your response to the solicitation.

Complete Part 1 below if: Supplier is certified by the State of Washington Office of Minority and Women's Business Enterprises (OMWBE).

Complete Part 2 below if: Supplier is proposing to subcontract or joint venture with certified Minority Business Enterprises (MBE's) or Women's Business Enterprises (WBE's).

Complete Part 3 below if: Supplier proposes NO MWBE participation.

Complete Part 4 below if: Supplier is classified as a Federal Small Business.

Complete Part 5 below if: Supplier is proposing to subcontract or joint venture with a Small Business.

Complete Part 6 below if: Supplier proposes NO Small Business Participation

1. MWBE Certification:

Supplier is certified by the OMWBE as: (Check as applicable)

□MBE □Both Minority and Woman Owned

□WBE □Combination 50% Minority / 50% Woman Owned

2. MWBE Subcontract Participation:

The voluntary goals for MWBE participation in this contract are established in the accompanying solicitation. Supplier proposes to include certified MWBE's in the contract as described below:

Name(s) of Participating MWBE: ____________________________________________

Description of Participation: ________________________________________________ Dollar amount of Participation: $______________ Contract Percentage of Participation: __________

3. NO MWBE Participation Proposed:

Signed: ______________________________________________ (Supplier or authorized representative)

Title: ________________________________________________

UWMC Int. – 03.06.2020 Rev. 19 – 08.06.2025

Federal Small Business Certification Response - Check the appropriate box:

□ Small Business □Disadvantaged Small Business

□ Women Owned Small Business □Veteran Owned Small Business

□ Service Disabled Veteran Owned Small Business

□ HUBZone Small Business □ANC’s & Indian Tribes not certified by SBA

□ ANCs & Indian Tribes not small business

Include the four digit Standard Industrial Classification NAICS code, if known:

4. Small Business Subcontract Participation:

The voluntary goals for Federal Small Business participation in this contract are established in the accompanying solicitation. Supplier proposes to include the contract as described below:

Name(s) of Participating Small Business_____________________________________

Description of Participation: _______________________________________________ Dollar amount of Participation: $______________ Contract Percentage of Participation: __________ %

5. NO Small Business Participation Proposed:

Signed: ______________________________________________ (Supplier or authorized representative)

Title: ________________________________________________

INFORMATION REGARDING STATE AND FEDERAL CERTIFICATIONS

State of Washington Minority and Women’s Business Enterprises Participation

General Statement:

In accordance with the legislative findings and policies set forth in Chapter 39.19 RCW, the State of Washington encourages participation in all of its contracts by MWBE firms certified by the Office of Minority and Women’s Business Enterprises (OMWBE) http://www.ombwe.wa.gov.

Participation may be either on a direct basis in response to this solicitation/invitation or as a subcontractor to a Supplier/Proposer.

UWMC Int. – 03.06.2020 Rev. 19 – 08.06.2025

However, unless required by federal statutes, regulations, grants or contract terms referenced in the contract documents, no preference will be included in the evaluation of bids/proposals. No minimum level of MWBE participation shall be required as a condition for receiving an award and bids/proposals will not be rejected or considered non-responsive on that basis. Any affirmative action requirements set forth in federal regulations or statutes included or referenced in the contract documents will apply.

Record Keeping:

The Contractor shall maintain, for at least three (3) years after completion of this contract, relevant records and information necessary to document the level of utilization of MWBEs and other businesses as subcontractors and suppliers in this contract as well as any efforts the Contractor makes to increase the participation of MWBEs as listed below. The Contractor shall also maintain, for at least three (3) years after completion of this contract, a record of all quotes, bids, estimates, or proposals submitted to the Contractor by all businesses seeking to participate as subcontractors or suppliers in this contract. The State shall have the right to inspect and copy such records. If this contract involves federal funds, Contractor shall comply with all record keeping requirements set forth in any federal rules, regulations or statutes included or referenced in the contract documents.

Affirmative Efforts to increase participation by MWBE’s:

Advertise opportunities for subcontractors or suppliers in a manner reasonably designed to provide MWBEs capable of performing the work with timely notice of such opportunities, and include a provision encouraging participation by MWBE bids/proposals directly from MWBEs.

1. Provide MWBEs that express interest with adequate and timely information about plans, specifications, and requirements of the Contract.

2. Break down total requirements into smaller tasks or quantities, where economically feasible, in order to permit maximum participation by MWBEs and other small businesses.

3. Establish delivery schedules, where the requirements of this contract permit, that encourage participation by MWBEs and other small businesses.

5. Reduce bonding requirements where practicable.

6. Utilize the services of available minority community organizations, minority contractors’ groups, local minority assistance offices and organizations that provide assistance in the recruitment and placement of MWBEs and other small businesses.

7. The actions described in this section should supplement efforts to provide information to all qualified firms, and nothing in this section is intended to prevent or discourage the Suppliers, Proposers, or Contractors from inviting proposals for participation from non- MWBE firms as well as MWBE firms.

Non-Discrimination:

Contractors, Suppliers, and Proposers shall not create barriers to open and fair opportunities for all businesses including MWBEs to participate in all State contracts and to obtain or compete for contracts and subcontracts as sources of supplies, equipment, construction and services. In considering offers from and doing business with subcontractors and suppliers, the Contractor shall not discriminate on the basis of race, color, creed, religion, sex, age, nationality, marital status, or the presence of any mental or physical disability in an otherwise qualified disabled person.

UWMC Int. – 03.06.2020 Rev. 19 – 08.06.2025

Federal Small, Small Disadvantaged or Small Woman Owned Business Certification In accordance with Public Law 95-507, Federal Contracts that contain Federal Acquisition Regulations (FAR) clause 52.219-8 (Utilization of Small Business Concerns and Small Disadvantaged Business Concerns) impose requirements regarding subcontracting with small businesses and small business subcontracting plans. Refer to FAR 19.001 for guideline definitions.

With regards to certification, the Small Business Administration (SBA) classifies small businesses on an industry-by-industry basis, utilizing a Standard Industrial Classification (SIC) code as described in the Code of Federal Regulations (CFR) Title 13, Part 121. The offeror certifies that the information is true and understands that whoever, for the purpose of securing a contract or subcontract is accountable under Public Law 99-661 and the CFR Title 13, Part 124 & 125.

If a firm misrepresents the status of any concern or person as a small business owned and controlled by a minority or woman owned business, they shall (1) be punished by imposition of a fine, imprisonment, or both; (2) be subject to administrative remedies including suspension and disbarment; and (3) be ineligible for participation in programs conducted under the authority of the Small Business Act.

If you need assistance in determining whether your business is considered to be small, contact the Seattle branch of the U.S. Small Business Administration at (206) 553-7310, or the University’s Representative at (206) 543-4156.

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