SBE_JOC-Contractor's_Statement_of_Utilization_Form.docx

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Attached to
STREET TRANSPORTATION DEPARTMENT PAVEMENT SURFACE TREATMENT PROGRAM
Solicitation number
JOC256
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This 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 for the Street Transportation Department Pavement Surface Treatment Program. The form requires contractors to document their proposed utilization of certified SBE firms to meet City-mandated SBE goals for specific job order agreements. Contractors must list each SBE firm that will be engaged, specify the scope of work to be performed by each firm, identify whether each firm qualifies as a supplier (limited to satisfying no more than 25 percent of the SBE goal), and provide the subcontract dollar amount for each firm. The form applies to individual job order agreements within the overall contract, with separate forms required for each JOA. For JOAs where no SBE firms will be utilized, contractors must indicate "none" on the form.

Only SBE firms certified with the City of Phoenix as of the proposal date will have their subcontract amounts counted toward meeting the required SBE goals. Contractors must calculate the total SBE dollar amount and the percentage of the overall contract value that SBE utilization represents. The form requires completion and signature by an authorized company representative, including the contractor's company name, email, phone number, and the name and title of the signatory. Qualifications for the underlying pavement surface treatment program were due to the City's Procurement Portal by 12:00 pm on Friday, May 1, 2026.

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Text version

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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