Schedule for Participation WBE MBE~17.pdf

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Attached to
DRM 2026-80 Solar Canopy Parking Surface Course Paving and Line Striping
Solicitation number
BD-27-1025-DOCFS-9800-132713
Issued by
Massachusetts

About this file

This is a Schedule for Participation form for Minority Business Enterprise (MBE) and Women Business Enterprise (WBE) participation, issued by the Division of Capital Asset Management and Maintenance (DCAMM) for use on Massachusetts construction projects governed by c.149, 44A and c.30, 39M. The form is submitted in connection with the DRM 2026-80 Solar Canopy Parking Surface Course Paving and Line Striping project, estimated at $130,000.00. Prime contractors and general contractors must submit the completed schedule to DCAMM's Compliance Office within five working days of the opening of general bids. Filed sub-bidders that are themselves MBE/WBE certified or that utilize MBE/WBE firms must submit the schedule attached to their filed sub-bid. The form requires bidders to identify all MBE/WBE firms intended for use on the project, detailing the scope of work, specification sections, type of participation (labor and material, material only, or labor only), and total dollar value of participation for each firm.

The schedule establishes contractual commitments for MBE and WBE participation, with bidders required to certify that if awarded the contract, they will expend at least the specified amounts for MBE/WBE participation. For material suppliers, only 15 percent of the total value of supplies counts toward the value of participation. The form captures separate commitment percentages and dollar amounts for both MBE and WBE goals, with bidders providing authorized signature and contact information to bind their firm to the stated commitments. The form must reference the MBE/WBE certification issued by the Massachusetts Supplier Diversity Office as defined in Article XIII of the contract, and suspected fraud or misuse in DCAMM's MBE/WBE program should be reported to www.mass.gov/dcamm-contract-compliance.

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Bid Intent Form~16.docx DOCX document
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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 ____________________________

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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