Section 3 - Good Faith Effort.docx
DOCX document 132 KB Posted
- Attached to
- BID 2022-16 2022 HVAC Upgrades
- Solicitation number
- S-X26083-00004208
- Issued by
- Multnomah County, Oregon
About this file
The document is a Good Faith Effort Subcontractor and Self-Performed Work List (Form 1) related to a contract opportunity issued by CareOregon, Inc. for the 2022 HVAC Upgrades project. The contract opportunity is seeking bids for the replacement of an existing gas-fired heating water boiler, installation of outside air ventilation fans, replacement of a condenser water pump and associated piping, pumps, valves, and other required work. The prime contractor must disclose and list all subcontractors, including any Minority-owned, Woman-owned, Service-Disabled Veteran, and Emerging Small Businesses firms, that they intend to use on the project. The completed form must be emailed to the procurement department within 2 hours of the bid/quote closing date and time.
The contract opportunity is for state and local jurisdictions including Multnomah County and the City of Portland. Pricing terms, set asides, and funding details are not provided in the document. The prime contractor must certify that the listed subcontractors have been utilized and the information is complete and accurate upon project completion.
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Text version
CAREOREGON, INC.
GOOD FAITH EFFORT
SUBCONTRACTOR AND SELF-PERFORMED WORK LIST
(FORM 1)
| Prime Contractor Name: |
| Total Contract Amount: |
Project Name: 2022 HVAC Upgrades Project
PRIME SELF-PERFORMING: Identify below ALL GFE Divisions of Work (DOW) to be self-performed. Good Faith Efforts are otherwise required.
DOW BIDDER WILL SELF-PERFORM (GFE not required)
PRIME CONTRACTOR SHALL DISCLOSE AND LIST ALL SUBCONTRACTORS, including those Minority-owned, Woman-owned, Service-Disabled Veteran, and Emerging Small Businesses firms (“M/W/SDV/ESB”) that you intend to use on the project. Email to Procurement at procurement@careoregon.org within 2 hours of the BID/Quote Closing Date/Time
LIST ALL SUBCONTRACTORS BELOW
Use correct legal name of Subcontractor (No Assumed Business Names) Division of Work (Painting, electrical, landscaping, etc.)
List ALL DOW performed by Subcontractors
DOLLAR
AMOUNT OF
SUBCONTRACT
If certified or self-reporting MBE/WBE/ESB/SDV Subcontractor
Check box
MBE
WBE
SDV
ESB
Name
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
Phone#
OCCB#
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GFE SUBCONTRACTOR AND SELF-PERFORMED WORK LIST (FORM 1) cont’d
Use correct legal name of Subcontractor (No Assumed Business Names) Division of Work (Painting, electrical, landscaping, etc.)
List ALL DOW performed by Subcontractors
DOLLAR
AMOUNT OF
SUBCONTRACT
If certified or
SDV
ESB
Name
Address
City/St/Zip
Phone#
OCCB#
| ☐ | ||
| ☐ | ☐ | ☐ |
| Name |
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
Phone#
OCCB#
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| Name |
Address
City/St/Zip
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CareOregon, Inc. GFE (8/2022) Page 2 of 4
GOOD FAITH EFFORT
M/W/SDV/ESB CONTACT / BIDS RECEIVED LOG
(FORM 2)
Prime Contractor:
Project:
Prime Contractor must contact or endeavor to contact at least 3 M/W/SDV/ESB Subcontractors for each Division of Work. Prime Contractor shall record its contacts with M/W/SDV/ESB Subcontractors through use of this log (or equivalent) entering all required information. All columns shall be completed where applicable. Additional forms may be copied if needed.
| NAME OF M/W/SDV/ESB SUBCONTRACTOR |
| Divisions of Work |
(Painting, electrical, landscaping, etc.)
| Date Sollicitation Email / Fax Sent |
| PHONE CONTACT |
| BID ACTIVITY |
Check Yes or No
REJECTED BIDS
(if bid received & not used)
Notes
Will Bid
Bid Received
Bid Used
| Bid Amount |
| Reason Not Used |
(Price, Scope or Other. If Other, explain in Notes>>)
| Date of Call |
| Person Receiving Call |
CareOregon, Inc. (8/2022) Page 4 of 4
GOOD FAITH EFFORT
PROJECT COMPLETION REPORT
(FORM 3)
Prime Contractor Name: Total Contract Amount:
Project Name:
Complete this form and submit with your request for final payment upon the project completion. Please list all subcontractors used for the project. Use additional sheets as necessary.
Use correct legal name of Subcontractor (No Assumed Business Names) Division of Work (Painting, electrical, landscaping, etc.)
List ALL DOW performed by Subcontractors
DOLLAR
AMOUNT OF
SUBCONTRACT
If certified or
SDV
ESB
Name
Address
City/St/Zip
Phone#
OCCB#
| ☐ | ||
| ☐ | ☐ | ☐ |
| Name |
Address
City/St/Zip
Phone#
OCCB#
| ☐ | ||
| ☐ | ☐ | ☐ |
| Name |
Address
City/St/Zip
Phone#
OCCB#
| ☐ | ||
| ☐ | ☐ | ☐ |
| Name |
Address
City/St/Zip
Phone#
OCCB#
| ☐ | ||
| ☐ | ☐ | ☐ |
| Name |
Address
City/St/Zip
Phone#
OCCB#
| ☐ | ||
| ☐ | ☐ | ☐ |
BY SIGNING BELOW, I HEREBY CERTIFY THAT THE ABOVE LISTED FIRMS HAVE BEEN UTILIZED BY OUR COMPANY IN THE AMOUNTS REPRESENTED ABOVE AND THAT THE INFORMATION CONTAINED HEREIN IS COMPLETE AND ACCURATE.
Authorized Signature of Contractor Representative Date image2.wmf image3.wmf image4.wmf image5.wmf image6.wmf image1.jpeg
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