schedule-for-participation-by-mwbe-construction~8.pdf

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Attached to
DRM 2018-46 #10 Conduit Installation at NCCI Gardner
Solicitation number
BD-26-1025-DOCFS-9848-122529
Issued by
Worcester County, Massachusetts

About this file

This is a Schedule for Participation form issued by the Division of Capital Asset Management and Maintenance (DCAMM) for Minority/Women Business Enterprises (MBE/WBE) on construction projects governed under Massachusetts c.149, §44A and c.30, §39M. The form is used to document bidder commitments to utilizing certified MBE/WBE firms for materials and services on DCAMM-funded construction projects. Filed sub-bidders who are themselves MBE/WBE certified or who utilize MBE/WBE firms must submit this schedule with their bid, while prime and general contractors must submit the completed form to DCAMM's Compliance Office within five working days of the opening of general bids.

Bidders must specify each MBE/WBE firm they intend to utilize, including the company name and address, certification type (MBE or WBE), scope of work to be performed with specification sections, type of participation (labor and material, material only, or labor only), and total dollar value of participation. For material suppliers, only 15 percent of the total material value counts toward the participation goal. The form requires documentation of both MBE and WBE project goals stated as percentages and dollar amounts, with corresponding total commitment values. An authorized representative of the bidding firm must certify that they have read the contract terms regarding MBE/WBE participation and are authorized to bind the bidder to the stated commitments. Suspected fraud or misuse in the program can be reported at www.mass.gov/dcamm-contract-compliance.

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Schedule for Participation –Construction–2020 To Report Suspected Fraud or Misuse in DCAMM’s MBE/WBE Program go to: www.mass.gov/dcamm-contract-compliance

SCHEDULE FOR PARTICIPATION

BY MINORITY/WOMEN BUSINESS ENTERPRISES

DIVISION OF CAPITAL ASSET MANAGEMENT AND MAINTENANCE

For use on c.149, §44A and c.30, §39M projects

DCAMM Project Number ____________________________ Project Location ______________________________________

DCAMM Project Name ___________________________________________________________________________________

A. Filed Sub-Bidders that are 1) themselves MBE/WBE certified and/or 2) Utilizing MBE/WBE firm(s) to provide materials or services – submit with and attach to Filed Sub-Bid

B. Prime/General Contractor must submit to DCAMM’s Compliance Office within five (5) working days of the opening of General Bids.

BIDDER CERTIFICATION:

The Bidder agrees that if awarded the contract it will expend at least the amount of the contract set forth below for MBE/WBE participation. For purposes of this commitment, the MBE and WBE designation means that a business has been certified by

Massachusetts Supplier Diversity Office (“SDO”) as either an MBE, WBE or M/WBE, see Article XIII of the Contract. The Bidder must indicate the MBE/WBE firms it intends to utilize on the project as follows (attach additional sheets if necessary):

MBE/WBE Company Name

& Address

MBE

or

WBE

Describe Scope(s) of Work

MBE/WBE firm is performing including Spec. Section(s)

(Indicate whether providing

“Labor and Material” “Material

Only” or “Labor Only”

If MBE/WBE is a

Material Supplier, Indicate Total Value of

Supplies (15% of total value counts toward

Value of Participation)

Total Dollar

Value of

Participation

1.

2.

3.

4.

5.

6.

7.

MBE Goal-(Percentage): ____% MBE Project Goal (dollars): $___________ Total Dollar Value of MBE Commitment: $___________

WBE Goal (Percentage): ____% WBE Project Goal (dollars): $___________ Total Dollar Value of WBE Commitment: $___________

The undersigned hereby certifies that he/she has read the terms and conditions of the contract regarding MBE/WBE participation and is authorized to bind the Bidder to the commitment set forth above.

Name of Firm __________________________________________ Authorized Signature ________________________________

Business Address _______________________________________ Print Name ________________________________________

Email ________________________________________________ Title _____________________________________________

Telephone #s: Office _______________________ Mobile _________________________ Date ____________________________

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