SBE_JOC-Contractor's_Statement_of_Utilization_Form.docx

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Attached to
STREET TRANSPORTATION DEPARTMENT FRACTURED AGGREGATE SURFACE TREATMENT (FAST) PROGRAM 2-STEP JOB ORDER CONTRACT
Solicitation number
JOC260
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This is a Small Business Enterprise (SBE) Program Contractor's Statement of Proposed SBE Utilization form for Job Order Contracts (JOC) administered by the City of Phoenix, Arizona. The form is designed for contractors to document their proposed use of certified SBE firms to meet required SBE utilization goals on specific job order agreements within the Street Transportation Department Fractured Aggregate Surface Treatment (FAST) Program 2-Step Job Order Contract. Contractors must submit qualifications through the City's Procurement Portal before 12:00 pm on Friday, October 23, 2026. The form requires contractors to identify the project number, contract number, JOA number, project description, and the total job order proposal amount, along with the required annual SBE goal percentage.

The form mandates that all SBE firms listed must be certified with the City of Phoenix as of the proposal date for their subcontract amounts to count toward meeting required goals. Contractors must itemize each SBE firm to be utilized, specify the scope of work to be performed, designate whether each firm is a supplier (limited to no more than 25 percent of the goal), provide the subcontract dollar amount, and calculate the percentage of the total contract value. For job order agreements where no SBE firms will be used, contractors must list "none." The form requires contractor signature, date, company name, email, phone number, and the name and title of the authorized representative submitting the statement.

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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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