Schedule for Participation WBE MBE~16.pdf
PDF 112 KB Posted
- Attached to
- DRM 2026-82 HSU Abatement at MCI-Norfolk
- Solicitation number
- BD-27-1025-DOCFS-9816-132678
- Issued by
- Norfolk County, Massachusetts
About this file
This is a Schedule for Participation form issued by the Division of Capital Asset Management and Maintenance (DCAMM) for use on Massachusetts construction projects funded under c.149, 44A, and c.30, 39M. The form is designed for bidders on state construction projects to document their participation with Minority Business Enterprise (MBE) and Women Business Enterprise (WBE) certified firms. Bidders must complete this schedule to specify which MBE/WBE firms they intend to utilize, describe the scope of work each firm will perform including specification sections, indicate whether services will be provided as labor and material, material only, or labor only, and state the total dollar value of participation for each firm. Filed sub-bidders who are themselves MBE/WBE certified or utilizing MBE/WBE firms must submit this schedule with their sub-bid, while prime contractors must submit the completed form to DCAMM's Compliance Office within five working days of the general bid opening. The form accommodates up to seven MBE/WBE firms and requires bidders to certify that they will expend at least the committed amount for MBE/WBE participation if awarded the contract.
The schedule requires bidders to specify separate percentage goals and dollar amounts for both MBE and WBE participation, with material suppliers' contributions counting at 15 percent of their total supply value toward the participation goal. Bidders must provide their firm name, authorized signature, business address, contact information, and title of the authorized representative. All MBE and WBE designations referenced must be certified by the Massachusetts Supplier Diversity Office (SDO) as defined in Article XIII of the contract. The form includes a fraud reporting mechanism directing bidders to www.mass.gov/dcamm-contract-compliance for reporting suspected fraud or misuse in DCAMM's MBE/WBE program.
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| PW Statement of Compliance~15.pdf | ||
| Plan Holders List DRM 2026 82.docx | DOCX document | |
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Text version
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 ____________________________
| DCAMM Project Number: |
| Project Location: |
| DCAMM Project Name: |
| MBE or WBE1: |
| Describe Scopes of Work MBEWBE firm is performing including Spec Sections Indicate whether providing Labor and Material Material Only or Labor Only1: |
| If MBEWBE is a Material Supplier Indicate Total Value of Supplies 15 of total value counts toward Value of Participation1: |
| Total Dollar Value of Participation1: |
| MBE or WBE2: |
| Describe Scopes of Work MBEWBE firm is performing including Spec Sections Indicate whether providing Labor and Material Material Only or Labor Only2: |
| If MBEWBE is a Material Supplier Indicate Total Value of Supplies 15 of total value counts toward Value of Participation2: |
| Total Dollar Value of Participation2: |
| MBE or WBE3: |
| Describe Scopes of Work MBEWBE firm is performing including Spec Sections Indicate whether providing Labor and Material Material Only or Labor Only3: |
| If MBEWBE is a Material Supplier Indicate Total Value of Supplies 15 of total value counts toward Value of Participation3: |
| Total Dollar Value of Participation3: |
| MBE or WBE4: |
| Describe Scopes of Work MBEWBE firm is performing including Spec Sections Indicate whether providing Labor and Material Material Only or Labor Only4: |
| If MBEWBE is a Material Supplier Indicate Total Value of Supplies 15 of total value counts toward Value of Participation4: |
| Total Dollar Value of Participation4: |
| MBE or WBE5: |
| Describe Scopes of Work MBEWBE firm is performing including Spec Sections Indicate whether providing Labor and Material Material Only or Labor Only5: |
| If MBEWBE is a Material Supplier Indicate Total Value of Supplies 15 of total value counts toward Value of Participation5: |
| Total Dollar Value of Participation5: |
| MBE or WBE6: |
| Describe Scopes of Work MBEWBE firm is performing including Spec Sections Indicate whether providing Labor and Material Material Only or Labor Only6: |
| If MBEWBE is a Material Supplier Indicate Total Value of Supplies 15 of total value counts toward Value of Participation6: |
| Total Dollar Value of Participation6: |
| MBE or WBE7: |
| Describe Scopes of Work MBEWBE firm is performing including Spec Sections Indicate whether providing Labor and Material Material Only or Labor Only7: |
| If MBEWBE is a Material Supplier Indicate Total Value of Supplies 15 of total value counts toward Value of Participation7: |
| Total Dollar Value of Participation7: |
| MBE GoalPercentage: |
| MBE Project Goal dollars: |
| Total Dollar Value of MBE Commitment: |
| WBE Goal Percentage: |
| WBE Project Goal dollars: |
| Total Dollar Value of WBE Commitment: |
| Name of Firm: |
| Business Address: |
| Print Name: |
| Email: |
| Title: |
| Telephone s Office: |
| Mobile: |
| Date: |
| MBEWBE Company Name Address: |
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