RFQ_Exhibit_C_-_DBE_&_SBE_Proposer's_Information_Request_Form.xlsx
XLSX spreadsheet 32 KB Posted
- Solicitation number
- 26-05
- Issued by
- Alameda County, California
About this file
This file is an instruction form and template for the Transbay Joint Powers Authority (TJPA) Disadvantaged Business Enterprise (DBE) and Small Business Enterprise (SBE) Proposer's Information Request, designed to capture workforce diversity metrics from respondents to RFQs and Statements of Qualifications. The document provides comprehensive instructions for completing Form O (standard proposer format) and Form O (JV) (joint venture format), requiring respondents to identify all DBE/SBE firms claimed for credit, list subconsultant names and work items, provide proof of current DBE/SBE certification, and submit signed Intent to Perform letters from all subconsultants. The TJPA accepts DBE participation only from firms certified through the California Unified Certification Program (CUCP), while SBE certifications are accepted from CUCP, the San Francisco Contract Monitoring Division, and the State of California Department of General Services. All sections must be completed regardless of DBE/SBE participation status, with respondents required to provide detailed firm information including business name and address, contact details, firm age, nature of work, NAICS codes, annual gross receipts, certification status and type, and percentage of contract participation totaling 100 percent.
The form serves as a federally-required bidders list maintenance tool and DBE/SBE program monitoring mechanism, capturing critical small business participation data from all respondents. Firms must identify the specific type of DBE classification if applicable (African-American, Hispanic, Native American, Asian-Pacific, Asian-Indian, Female-Woman, or Other as designated by the Small Business Administration), with certification verification required through documentation attached to the proposal. No pricing information, contract award amounts, or financial terms are addressed within this instruction and form document; rather, it functions as a standardized data collection instrument to ensure transparency and compliance with federal and local small business contracting goals and monitoring requirements.
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|---|---|---|
| RFQ_Exhibits_D,_E,_and_G.zip | ZIP file | |
| RFQ_Exhibit_F_-_Agreement_Exceptions.docx | DOCX document | |
| RFQ_Exhibit_B_-_Administrative_and_Legal_Forms.docx | DOCX document | |
| RFQ_Exhibit_A_-_Tech_Forms.docx | DOCX document | |
| 26-05_-_10-UR_Request_for_Qualifications.pdf | ||
| RFPQ_#26-05_ED_RFPQ_Staff_List_and_Schedule.xlsx | XLSX spreadsheet | |
| RFPQ_#26-05_Eating_Disorder_Treatment_Services_Bid_Response.docx | DOCX document | |
| RFPQ_#26-05_Eating_Disorder_Treatment_Services.docx | DOCX document |
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Text version
Instructions
| How to fill out the DBE/SBE Proposer's Information Request Form |
| 1. Name of Project/Proposal – insert name of the TJPA Request for Qualifications (RFQ) |
| 2. Project/Proposal – insert TJPA-assigned number of the relevant RFQ |
| 3. Respondent Business Name and Address – insert company name and address of prime consultant. If proposal is being made by a joint venture, use the alternate JV form, Form Q (JV). |
| 4. Name of Person Submitting Proposal – insert contact name of person submitting Proposal/SOQ on behalf of firm |
| 5. Signature of Respondent – signature of person listed in number 4 |
| 6. Date – date Proposal/SOQ is being submitted |
| 7. Contact Person Name – insert contact name for the Proposer/Respondent |
| 8. Contact Person Number – insert telephone number of contact person for the Proposer/Respondent |
| 9. Contact Email – insert email address of contact person for the Proposer/Respondent |
| 10. Note the requirements in small print – “IMPORTANT: 1) Identify all DBE/SBE firms being claimed for credit. 2) List names of all DBE/SBE subconsultant and their respective items of work. 3) Attach copy of the proof of DBE/SBE certification for each DBE/SBE subconsultant listed on this form. 4) Attach “Intent to Perform” letter signed by the subconsultant.” |
| Certification must be attached. The TJPA accepts DBE participation only from firms currently certified in the California Unified Certification Program (CUCP). For SBE participation, certifications are accepted from the CUCP, the San Francisco Contract Monitoring Division, and/or the State of California Department of General Services. If a proposal includes subconsultants, a letter stating the subconsultant’s intent to perform work on the project must be attached. |
| 11. Sections A and B must be completed, even if there is no DBE/SBE participation planned for the contract. The information in this section is required for TJPA DBE/SBE Program monitoring purposes and for maintaining a federally required bidders list. Do not write “not applicable” or “n/a”. If a proposal is being submitted by one firm or individual, with no partners or subconsultants, then that firm or individual is the Proposer and must complete Section A. Even if the name, address and phone number are the same as provided above on the form, the remaining columns must be completed; do not write “same as above”. All subconsultants, whether DBE/SBE or non-DBE/SBE, must be listed in Section B. Use additional sheets if necessary. If there are no subconsultants proposed, Section B will remain blank. |
| · Age of firm – how many years the firm has been in business |
| · Item of Work, Service or Materials Supplied – what is the respective item of work the firm will provide for the contract |
| · NAICS Code – North American Industry Classification System Code. Codes can be found at www.census.gov/naics. |
| · Annual Gross Receipts of Firm – a range may be provided, e.g., less than $500,000; $500,000 - $1,000,000; $1,000,000 - $5,000,000; $5,000,000 - $10,000,000; etc. |
| · Certified DBE/SBE – mark yes or no in this column. If “yes”, list the type of certification: CUCP, CMD, DGS. |
| · DBE/SBE Certifying Agency – if you marked yes as a Certified DBE/SBE, note which agency your certification letter is from—BART, SFMTA, CMD, etc. |
| · Type of DBE– if you marked yes as a Certified DBE, put the number that corresponds to the type of DBE as follows— |
| 1. African-American |
| 2. Hispanic |
| 3. Native American |
| 4. Asian-Pacific |
| 5. Asian-Indian |
| 6. Female-Woman |
| 7. Other |
| · Award Amount – leave this column blank, unless you are submitting an updated form after contract award |
| · Percentage of Contract Participation – if only one firm or individual is proposing/responding, with no partners or subconsultants, this is 100% for the Proposer/Respondent. Fill in appropriate percentages for each firm if some of the work is being subcontracted. Note that the total at the bottom of the form must be 100% when all percentages are added. |
| Use additional sheets if necessary. If there are no subconsultants proposed/submitted, Section B will remain blank. |
&"Times New Roman,Bold"&14TRANSBAY JOINT POWERS AUTHORITY
EXHIBIT C - DBE/SBE: FORM O INSTRUCTIONS
http://www.census.gov/naics Form O To be completed by Respondent and submitted as part of Statement of Qualifications.
NAME OF PROJECT/PROPOSAL PROJECT/PROPOSAL NUMBER
PROPOSER BUSINESS NAME AND ADDRESS
NAME OF PERSON SUBMITTING BID SIGNATURE OF PROPOSER DATE
CONTACT PERSON NAME CONTACT PHONE NUMBER CONTACT EMAIL
| IMPORTANT: 1) Identify all DBE/SBE firms being claimed for credit. 2) List names of all DBE/SBE subcontractors and their respective items of work. 3) Attach a copy of the proof of DBE/SBE certification for each DBE/SBE subcontractor listed on this form. 4) Attach "Intent to Perform" letter signed by the subcontractor. | |
| DBE Participation | |
| LIST BUSINESS FIRM(s) |
List Name, Address, and Contact Person
| (if not the same as above) | Phone Number | Email Address | Age of Firm | Item of Work, Service or Materials Supplied | NAICS Code |
| (if known) * | Annual Gross Receipts of Firm | Certified DBE | |||
| (Y/N) | Certified |
SBE
| (Y/N) | DBE/SBE Certifying Agency | Type of DBE ** | Award Amount | Percentage of Contract Participation |
| A. Proposer |
B. Subcontractor/Vendor
TOTAL $0 0.00%
| * NAICS Code: North American Industry Classification System Code. Codes can be found at https://www.census.gov/naics/ |
| ** Type of DBE: (1) African-American (2) Hispanic (3) Native American (4) Asian-Pacific (5) Asian-Indian (6) Female-Woman (7) Other (designated by the Small Business Administration) |
| - DBEs must be certified by Caltrans or an agency participating in the California Unified Certification Program. Visit the Caltrans website at https://caltrans.dbesystem.com/ for a list of participating agencies. |
| - SBEs must be certified by the City & County of San Francisco Contract Monitoring Division and/or the State of California Department of General Services https://caleprocure.ca.gov/pages/sbdvbe-index.aspx |
| - Important: Attach the proof of certification for each DBE/SBE firm used toward meeting the DBE/SBE goal. |
| - This information will be used to create and maintain a federally-required Bidders List, regardless of DBE/SBE participation. |
| - Use additional sheets as necessary. |
&"Times New Roman,Bold"&14TRANSBAY JOINT POWERS AUTHORITY
FORM O – DBE/SBE PROPOSER'S INFORMATION REQUEST FORM
&"Times New Roman,Regular"Page &P of &N
Form O (JV) To be completed by Respondent (Joint Venture) and submitted as part of Statement of Qualifications.
NAME OF PROJECT/PROPOSAL PROJECT/PROPOSAL NUMBER
RESPONDENT BUSINESS NAME AND ADDRESS
NAME OF PERSON SUBMITTING BID SIGNATURE OF RESPONDENT DATE
CONTACT PERSON NAME CONTACT PHONE NUMBER CONTACT EMAIL
| IMPORTANT: 1) Identify all DBE/SBE firms being claimed for credit. 2) List names of all DBE/SBE subcontractors and their respective items of work. 3) Attach a copy of the proof of DBE/SBE certification for each DBE/SBE subcontractor listed on this form. 4) Attach "Intent to Perform" letter signed by the subcontractor. | |
| DBE-SBE Participation | |
| LIST BUSINESS FIRM(s) |
List Name, Address, and Contact Person
| (if not the same as above) | Phone Number | Email Address | Age of Firm | Item of Work, Service or Materials Supplied | NAICS Code |
| (if known) * | Annual Gross Receipts of Firm | Certified DBE | |||
| (Y/N) | Certified |
SBE
| (Y/N) | DBESBE Certifying Agency | Type of DBE ** | Award Amount | Percentage of Contract Participation |
| A. JOINT VENTURE Partners |
B. Subcontractors/Vendors
TOTAL $0 0.00%
| * NAICS Code: North American Industry Classification System Code. Codes can be found at http://www.census.gov/naics. |
| ** Type of DBE/SBE: (1) African-American (2) Hispanic (3) Native American (4) Asian-Pacific (5) Asian-Indian (6) Female-Woman (7) Other (designated as a Small Business) |
| - DBEs must be certified by Caltrans or an agency participating in the California Unified Certification Program. Visit the Caltrans website at https://caltrans.dbesystem.com/ for a list of participating agencies. |
| '- SBEs must be certified by the City & County of San Francisco Contract Monitoring Division and/or the State of California Department of General Services https://caleprocure.ca.gov/pages/sbdvbe-index.aspx |
| - Important: Attach the proof of certification for each DBE/SBE firm used toward meeting the DBE/SBE goal. |
| - This information will be used to create and maintain a federally-required Bidders List, regardless of DBE/SBE participation. |
| - Use additional sheets as necessary. |
&"Times New Roman,Bold"&12TRANSBAY JOINT POWERS AUTHORITY
FORM O
(JV) – DBE/SBE PROPOSER'S INFORMATION REQUEST FORM
&P of &N
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