TSB Form.pdf

PDF 56 KB Posted

Attached to
Waterloo Vehicle Maintenance Shop
Solicitation number
C485X2118
Issued by
Black Hawk County, Iowa

About this file

This Targeted Small Business (TSB) Form is a supplemental bidding document required by the Iowa Department of Public Defense for the Waterloo Vehicle Maintenance Shop construction project (Contract No. C485X2118, Project No. 190185). The form must be submitted alongside the Form of Bid and requires bidders to identify whether they are certified Iowa Targeted Small Businesses and to document all affirmative outreach efforts made to TSB enterprises prior to bid submission. Bidders are instructed to use the construction-related Iowa Targeted Small Business Directory as certified by the Department of Economic Development, State of Iowa, and must comply with all affirmative action and equal opportunity provisions of State and Federal laws. The form requests bidders to record the name and phone number of each TSB company contacted, the date of contact, whether a quote was received, and the dollar amount of any quote incorporated into the bid, with additional space provided for multiple contacts.

The TSB Form enforces Iowa's commitment to providing contracting opportunities to Targeted Small Businesses in accordance with Chapter 73 of the Code of Iowa, with all information subject to verification and confirmation. The form must be signed by the same individual authorized to sign the Form of Bid, establishing accountability for the accuracy of the documented small business engagement efforts. This requirement applies uniformly to all bidders regardless of their own business classification and represents a mandatory compliance element of the overall bid submission for the approximately 24,805 square-foot Vehicle Maintenance Shop facility.

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Text version

WATERLOO VEHICLE MAINTENANCE SHOP SUPPLEMENT D:

WATERLOO, 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:

WATERLOO VEHICLE MAINTENANCE SHOP

PROJECT LOCATION:

WATERLOO, IOWA

PROJECT NO.: 190185

CONTRACT NO.: C485X2118

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

File details come from the government source that posted it. Updated .