SUBCONTRACTOR_INFORMATION_FORM_(FEDERAL_FUNDING)_(1).pdf

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SUBCONTRACTOR INFORMATION FORM

List all subcontractors that will be used for the Work along with the tasks they will provide. If the subcontractor is a small and minority-owned business, women’s business enterprise, or labor surplus firm, check the boxes that apply.

The selected prime Contractor will be asked to provide the actual subcontractor spend amount at a later date.

Subcontractors are not permitted to work at GRU if listed on the State of Florida Suspended Vendor List or the Federal Suspensions and Debarments.

• Small Business Enterprise (SBE): A business that is independently owned and operated and is qualified as a small business under the Small Business administration criteria and size standards at 13 C.F.R. Part 121.

• Women’s Business Enterprise (WBE): A business enterprise that is (a) at least 51% owned by one or more women, or in the case of a publicly owned business, at least 51% of the stock is owned by one or more women; and (b) whose management and daily operations are controlled by one or more women. (13 C.F.R. Part 127)

• Minority Business Enterprise (MBE): A business that is (a) at least 51% owned by one or more minority group members, or in the case of a publicly owned business, at least 51% of the stock is owned by one or more minority group members; and (b) whose management and daily operations are controlled by one or more minority group members. (13 C.F.R. § 124.103, 13 C.F.R. § 124.102, and 13 C.F.R. § 124.105).

• Labor Surplus Area (LSA): A locality, defined by the Department of Labor’s Employment and Training Administration, that has a civilian average annual unemployment rate during the previous two calendar years of 20% or more above the average annual civil unemployment rate for all states during that same period. (20. C.F.R. § 654.4-654.5). There is an “Exceptional Circumstance Consideration Provision” that allows a civil jurisdiction to ask for inclusion in the LSA list after it is published, due to events such as COVID-19, natural disasters, and other adverse economic changes.

• Labor Surplus Area Firm (LSAF): A firm that together with its first-tier subcontractors will perform substantially in LSAs as identified by the Department of Labor in accordance with 20. C.F.R. § 654. Performance is substantially in LSAs if the costs incurred under the contract on account of manufacturing, production, or performance of appropriate services in labor surplus areas exceed 50% of the contract price (40 C.F.R. § 33.103).

Subcontractor Name Goods or Service to be provided Business Type

SBE WBE MBE LSA LSAF

By signing this form, bidder certifies all subcontractors listed are not on the State of Florida Suspended Vendor List or the Federal Suspensions and Debarments.

By:

Name:

Title:

https://www.dms.myflorida.com/business_operations/state_purchasing/state_agency_resources/vendor_registration_and_vendor_lists/suspended_vendor_list https://sam.gov/content/exclusions https://www.dms.myflorida.com/business_operations/state_purchasing/state_agency_resources/vendor_registration_and_vendor_lists/suspended_vendor_list https://sam.gov/content/exclusions