SBE_JOC-Contractor's_Statement_of_Utilization_Form.docx

40 KB Posted

Attached to
BRIDGE AND DAM SAFETY REPAIR PROGRAM
Solicitation number
JOC240 - B
Issued by
Maricopa County, Phoenix City, Arizona

About this file

Written by GovTribe AI ·

The document is a Small Business Enterprise (SBE) Contractor's Statement of Proposed SBE Utilization form for Job Order Contracts (JOC) issued by the City of Phoenix. The form is designed for contractors to detail their proposed utilization of Small Business Enterprise firms for a specific project, with a designated annual SBE goal percentage. Contractors must list certified SBE firms, their scope of work, and subcontract amounts, with a limitation that suppliers may not satisfy more than 25% of the goal.

The form is associated with the City of Phoenix's Bridge and Dam Safety Repair Program, with qualifications to be submitted through the City's Procurement Portal by 12:00 pm on Friday, August 8, 2025. The document provides a template for contractors to demonstrate their commitment to utilizing small businesses in the project, requiring detailed information about each SBE firm's role, including company name, scope of work, and proposed subcontract amount. The form includes checkboxes for verification and requires the prime contractor's signature, contact information, and confirmation of the proposed SBE utilization strategy.

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Small Business Enterprise Program

CONTRACTOR’S STATEMENT OF PROPOSED SBE UTILIZATION - JOB ORDER CONTRACTS (JOC)

Project #: __________________ Contract #: ________________ JOA #: ________________

Project Description: __________________________________________________________

Job Order Proposal Amount: $__________________________________________________

Required Annual SBE Goal

Please list the SBE firms that will be utilized on the Job Order Agreement to meet the required goals.

Use a separate form for each JOA that is part of the overall contract. For JOA’s in which no SBE firms are to be used, list “none” in the spaces below. The SBE firms listed below must be certified with the City of Phoenix as of the proposal date or their subcontract amount will not be counted towards meeting the required goals.

COMPANY NAME
Scope of Work to be Performed
Supplier

(may not satisfy more than 25% of goal) Sub-Contract $ Amount

|_| YES |_| NO

|_| YES |_| NO

|_| YES |_| NO

|_| YES |_| NO

|_| YES |_| NO

|_| YES |_| NO

|_| YES |_| NO

% of Contract = %
Total SBE $
$

COMPANY NAME: EMAIL: PHONE:

NAME & TITLE: ____________________________________________________________________________________________

SIGNATURE: DATE:

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