SB FORM 2028-B fillable 3.29.24~1.pdf
PDF 158 KB Posted
- Attached to
- RR-24-4977 Jane Addams Memorial Tollway (I-90) Bridge Repairs Rockton Rd to Rote Rd MP 2. 6 to 14. 5
- Solicitation number
- 25-557THA-ENGCO-B-45901
- Issued by
- Rock Island County, Illinois
About this file
This is Form 2028-B, a Small Business Exception (SBE) form from the Illinois State Toll Highway Authority (ISTHA) that prime contractors must complete when requesting an exception to small business participation requirements. The form must be submitted when identifying a subcontractor and must accurately represent the work and pricing agreed upon between the prime contractor and subcontractor.
The form requires prime contractors to document their efforts to achieve Small Business Initiative (SBI) participation through a detailed checklist of activities and a contact log. Contractors must demonstrate they identified contract portions suitable for SBI firms, conducted outreach through reasonable means, provided adequate contract information, negotiated in good faith, assisted with bonding/insurance requirements if applicable, and utilized available resources like the Tollway Technical Assistance Program. The form includes spaces to document specific SBI firms contacted, methods of contact, scope of work discussed, and reasons why agreements were not reached. An affidavit of truthfulness must be signed affirming the accuracy of the documented efforts. The form emphasizes that contractors cannot remove or reduce commitments to firms listed in the initial Small Business Plan without ISTHA's written consent.
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Text version
ILLINOIS STATE TOLL HIGHWAY AUTHORITY
Small Business Form 2028-B
Small Business Exception (SBE)
PRIME CONTRACTOR: ________________________________
CONTRACT NUMBER: __________________________ CONTACT NAME: ____________________________________
CONTACT PHONE: ___________________________________
CONTACT EMAIL: ____________________________________
Instructions to vendors:
1. Contractors are required to comply with the Special Provision.
2. This SBE Form 2028-B must:
• be submitted when the identification of a subcontractor is indicated
• be an accurate representation of work and pricing agreed upon between the prime and the subcontractor
1. In no case should a Contractor remove, replace or reduce the commitment to a firm listed in the initial Small Business Plan without prior written consent of ISTHA. Any changes that may affect the DBE/VOSB participation shall be requested in accordance with the DBE and VOSB Special Provisions.
Request for Small Business Exception
Non-SBI firm name proposed Scope of work solicited % of exception $ of exception
Demonstration of efforts to Achieve SBI Subcontractor Participation
If SBI contractor participation could not be met, the checklist and contacts log must be submitted with the contract documentation. Failure to do so may render the bidder’s solicitation response non-responsive and cause it to be rejected, or render the bidder ineligible for contract award, at ISHTA’s sole discretion. The bidder must provide all evidence relied upon in support of its efforts with its bid.
SBI Exception Checklist
Insert on each line below the initials of the authorized bidder representative who is certifying the bidder has completed the activities described below. If any of the items were not completed, attach a detailed written explanation. If any other efforts were made to obtain SBI participation in addition to the items listed below, attach a detailed written explanation.
______Identified portions of the contract work capable of performance by available SBI firms.
______Solicited through reasonable and available means (e.g., pre-bid meetings, networking session, written notices, advertisements) SBI firms to perform the types of work that could be subcontracted on this project, within sufficient time to allow them to respond.
Vendors may only submit one subcontractor exception per form.
SBI (and/or SBSP) Directory:
Illinois Tollway SBI Directory: https://iltollway.diversitysoftware.com/
Illinois Procurement Gateway SBSP Directory: https://ipg.illinois.gov/
______Provided timely and adequate information about the plans, specifications and requirements of the contract.
______Followed up initial solicitations to answer questions and encourage SBI firms to submit bids.
______Negotiated in good faith with interested SBI firms that submitted bids and thoroughly investigated their capabilities.
______Made efforts to assist interested SBI firms in obtaining bonding, lines of credit, or insurance as may be required for performance of the contract (if applicable).
______Utilized resources available to identify available SBI firms, including but not limited to the Tollway Technical Assistance Program (https://www.illinoistollway.com/doing-business/diversity-development/programs/technical-assistance), small business assistance groups; local, state and federal small business assistance offices; and other organizations that provide assistance in the recruitment and placement of small businesses.
Section 2 Request for Small Business Exception – continued
SBI Contact Log for Soliciting SBI Participation*
SBI firm name Date & method of contact & follow up
Scope of work solicited (include NIGP/NAICS)
Include bid submitted by SBI firm Reason agreement was not reached https://iltollway.diversitysoftware.com/ https://ipg.illinois.gov/
*Duplicate log as needed to capture all activity.
Affidavit of Truthfulness: Signature below affirms accuracy of efforts and authority to provide above information
Print Name: _________________________ Phone contact: __________________________
Position: ___________________________ E-mail address: _________________________
Signature: ____________________________ Date: __________________________________
| CONTRACT NUMBER: |
| PRIME CONTRACTOR: |
| CONTACT NAME: |
| CONTACT PHONE: |
| CONTACT EMAIL: |
| NonSBI f rm name proposedRow1: |
| Scope of work sol c tedRow1: |
| of except onRow1: |
| of except onRow1_2: |
| Identified portions of the contract work capable of performance by available SBI firms: |
| Solicited through reasonable and available means eg prebid meetings networking session: |
| Provided timely and adequate information about the plans specifications and requirements of the: |
| Followed up initial solicitations to answer questions and encourage SBI firms to submit bids: |
| Negotiated in good faith with interested SBI firms that submitted bids and thoroughly investigated: |
| Made efforts to assist interested SBI firms in obtaining bonding lines of credit or insurance as may: |
| Utilized resources available to identify available SBI firms including but not limited to the Tollway: |
| SBI f rm nameRow1: |
| Date method of contact follow upRow1: |
| Scope of work sol c ted include NIGPNAICSRow1: |
| Inc ude bid subm tted by SBI f rmRow1: |
| Reason agreement was not reachedRow1: |
| SBI f rm nameRow2: |
| Date method of contact follow upRow2: |
| Scope of work sol c ted include NIGPNAICSRow2: |
| Inc ude bid subm tted by SBI f rmRow2: |
| Reason agreement was not reachedRow2: |
| SBI f rm nameRow3: |
| Date method of contact follow upRow3: |
| Scope of work sol c ted include NIGPNAICSRow3: |
| Inc ude bid subm tted by SBI f rmRow3: |
| Reason agreement was not reachedRow3: |
| SBI f rm nameRow4: |
| Date method of contact follow upRow4: |
| Scope of work sol c ted include NIGPNAICSRow4: |
| Inc ude bid subm tted by SBI f rmRow4: |
| Reason agreement was not reachedRow4: |
| SBI f rm nameRow5: |
| Date method of contact follow upRow5: |
| Scope of work sol c ted include NIGPNAICSRow5: |
| Inc ude bid subm tted by SBI f rmRow5: |
| Reason agreement was not reachedRow5: |
| SBI f rm nameRow6: |
| Date method of contact follow upRow6: |
| Scope of work sol c ted include NIGPNAICSRow6: |
| Inc ude bid subm tted by SBI f rmRow6: |
| Reason agreement was not reachedRow6: |
| SBI f rm nameRow7: |
| Date method of contact follow upRow7: |
| Scope of work sol c ted include NIGPNAICSRow7: |
| Inc ude bid subm tted by SBI f rmRow7: |
| Reason agreement was not reachedRow7: |
| SBI f rm nameRow8: |
| Date method of contact follow upRow8: |
| Scope of work sol c ted include NIGPNAICSRow8: |
| Inc ude bid subm tted by SBI f rmRow8: |
| Reason agreement was not reachedRow8: |
| SBI f rm nameRow9: |
| Date method of contact follow upRow9: |
| Scope of work sol c ted include NIGPNAICSRow9: |
| Inc ude bid subm tted by SBI f rmRow9: |
| Reason agreement was not reachedRow9: |
| SBI f rm nameRow10: |
| Date method of contact follow upRow10: |
| Scope of work sol c ted include NIGPNAICSRow10: |
| Inc ude bid subm tted by SBI f rmRow10: |
| Reason agreement was not reachedRow10: |
| SBI f rm nameRow11: |
| Date method of contact follow upRow11: |
| Scope of work sol c ted include NIGPNAICSRow11: |
| Inc ude bid subm tted by SBI f rmRow11: |
| Reason agreement was not reachedRow11: |
| Print Name: |
| Phone contact: |
| Position: |
| Email address: |
| Date: |
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