TSB_Form (12).pdf
PDF 95 KB Posted
- Attached to
- S54 FINISH UPGRADES
- Solicitation number
- 34254102
- Issued by
- Polk County, Iowa
About this file
S54 Finish Upgrades - Targeted Small Business Form
This is a Targeted Small Business (TSB) Form supplement required for bidding on a facility renovation project by the Iowa Department of Public Defense at Camp Dodge in Johnston, Iowa (Project No. 19083733, Contract No. 34254102). The S54 Finish Upgrades project encompasses interior repainting work, latrine upgrades, replacement of select exterior doors, and installation of new room identification and wayfinding signage. Bids are due September 24, 2026, at 1:00 p.m. CDT. Bidders must submit all required documentation through the IMPACS event platform, including the Form of Bid and this TSB Form. The project is subject to all federal Buy American Act requirements. Issuing Officer Philip Payton can be contacted at 515-975-6211 or philip.payton@dpd.iowa.gov for additional information.
The TSB Form requires bidders to certify whether they are Iowa-certified Targeted Small Businesses and to document all Targeted Small Business Enterprise contacts made prior to bid submission, including company names, contact dates, quotes received, and proposed dollar amounts. Bidders must consult the construction-related Iowa Targeted Small Business Directory as certified by the Department of Economic Development, State of Iowa, and comply with all affirmative action and equal opportunity provisions of state and federal laws. The State of Iowa allows sixty days from invoice submission for payment under Iowa Code 8A.514. This supplement demonstrates the state's commitment to providing opportunities for certified small businesses as outlined in Chapter 73 of the Code of Iowa.
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Other files
| File | Type | Posted |
|---|---|---|
| Drawings.pdf | ||
| Advertisement for Bid.pdf | ||
| Specs.pdf | ||
| Advertisement Rev1.pdf | ||
| IFB_Specifications Rev1.pdf | ||
| Performance and Payment Bond (AIA Document A312-2010).html | HTML file | |
| Application and Certificate for Payment (AIA Documents G702 and G703-1992).html | HTML file | |
| Form_of_Bid Rev1.pdf | ||
| 1443205-event.pdf | ||
| General Conditions (AIA Document A201-2007).html | HTML file | |
| IFB_Drawings.pdf |
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Text version
S54 FINISH UPGRADES SUPPLEMENT D:
CAMP DODGE, JOHNSTON, IOWA TARGETED SMALL BUSINESS FORM
Revised Nov. 1, 2021 00 43 16 - 1
DOCUMENT 00 43 16
SUPPLEMENT D: TARGETED SMALL BUSINESS FORM
(To be submitted with Form of Bid)
I. PROJECT TITLE:
S54 FINISH UPGRADES
PROJECT LOCATION:
CAMP DODGE, JOHNSTON, IOWA
PROJECT NO.: 19083733
CONTRACT NO.: 34254102
Bidder’s Company Name Area Code/Telephone
Address City State Zip Code
Bidder is _____ is not _____ a certified Iowa Targeted Small Business.
INSTRUCTIONS: Bidder shall provide the information requested below showing any Targeted Small Business Enterprise contacts made prior to bid submission for the project listed. Bidder shall use the construction-related Iowa Targeted Small Business Directory as certified by the Department of Economic Development, State of Iowa. Bidders shall comply with all affirmative action/equal opportunity provisions of State and Federal laws. The Owner seeks to provide opportunities for Targeted Small Businesses in accordance with the provisions of Chapter 73 of the Code of Iowa. Information is subject to verification and confirmation.
TSB Company Name and Phone #
Date Contacted
Quote Rec’d (Y/N)
$ Amount Proposed (if quote used in bid)
(Use second sheet if needed)
Date Signature of Bidder (same person signing the Form of Bid)
END OF DOCUMENT 00 43 16
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