Fill - Free fillable CITY OF TAMPA, FLORIDA - RFQ (City of Tampa) PDF form

Rev. 2018-09-12

CITY OF TAMPA, FLORIDA - RFQ

c/o Contract Administration Department

306 East Jackson Street #280A4N

Tampa, Florida 33602

21-D-00016; El Prado Blvd. (Omar to Bayshore Blvd.) Complete Streets and Sidewalk Project Design

PUBLIC ANNOUNCEMENT IN COMPLIANCE WITH REQUIREMENTS OF SECTION 287.055, FLORIDA STATUTES (CONSULTANTS’ COMPETITIVE NEGOTIATION ACT)

APPLICABLE LAW, EXECUTIVE ORDERS, RULES, REGULATIONS, AND THE CITY’S STANDARD PROCEDURES. A NOTICE OF INTENT TO AWARD SHALL BE POSTED, IF AT ALL,

ON THE CITY’S WEBSITE ACCESSIBLE BY UTILIZING THIS WEBSITE LINK:

www.tampagov.net/contract-administration/programs/architectural-engineering-construction-and-related-rfqs .

The City of Tampa desires to obtain professional

Roadway Engineering, Landscape Architectural, and

Services for the design of El Prado Blvd. Complete

Streets and Sidewalk Project. Services will include but

may not be limited to; public involvement, including

virtual workshops or listening sessions; interagency and

rail coordination; surveying; subsurface utilities

exploration; traffic analysis; roadway and drainage

design; utilities

coordination; environmental permitting; miscellaneous

structures; signing and pavement markings; signalization,

landscaping and irrigation; resilient design, such as low

impact development, bioswales, rain gardens, etc.; urban

design; geotechnical services; cost estimating; cultural

resources and historic preservation coordination; Local

Agency Program (Transportation Alternatives)

coordination; construction cost estimating, preparation of

construction documents for bidding; and post-design

services.

Estimated fee is $575,000

Current Schedule;

2/11/21 Submission Deadline

3/5/21 Short-List

3/26/21 Presentations

4/9/21 Selection Announced

6/4/21 Negotiations Completed

7/1/21 Award

7/23/21 NTP

All relevant planning documents, corridor audits, and

traffic studies can be found at:

https://www.tampa.gov/tss-transportation/info/projects/el-

prado-blvd .

Additional material may be found at demandstar.com and at:

www.tampagov.net/contract-administration/programs/architectural-

engineering-construction-and-related-rfqs .

No further data will be available before the deadline established for

the submission of Letters-Of-Interest.

Questions may be directed to Jim Greiner, P.E., Contract

Administration, City of Tampa, (813) 274-8598, or E-Mail

jim.greiner@tampagov.net.

An individual or entity (“Firm”) responding to this RFQ must provide evidence of any

required licenses, certificates, or registrations with its submission or within 10 days

thereof in order to be considered. The City shall own all ideas, documents, plans,

and materials developed as a result of this solicitation and Firm is informed same

shall be subject to reuse in accordance with Section 287.055(10), Florida Statutes.

Firm (i) confirms it has read and is familiar with Section 119.071(3), Florida Statutes

regarding certain building plans, blueprints, schematic drawings, which depict the

internal layout and structural elements of a building, facility, or other structure owned

or operated by the City or other agency that are per said section exempt from

Section 119.07(1), Florida Statutes and Section 24(a), Art. I of the Florida

Constitution (“Exempt Plans”) and (ii) agrees Firm shall remain in compliance with

same, including maintaining the exempt status of such Exempt Plans for so long as

they are held by Firm or otherwise in its possession. The City may cancel, withdraw,

or modify this RFQ at any time and reserves the right to reject any or all responses

and to waive irregularities, formalities, and informalities as it determines in the City’s

best interest.

Firms desiring to provide these services to the City must submit a

single electronic file in searchable PDF format, Smaller than 5MB, that

includes the attached RFQ Transmittal Memorandum completed as

appropriate, a Letter of Interest addressed to Brad L, Baird, P.E.,

Chairman, and referring to this RFQ by number, together with a

Statement of Qualifications and any supplemental material allowing

evaluation for further consideration (short-listing) based upon the

following criteria/point system: Successful comparable Successful

Comparable Project experience (50); FDOT Local Agency Program

design experience (20); Past performance/Low amount of City work

(5); Standard Form #330 (5); Planned WMBE/SLBE Solicitation &

Utilization, Form MBD 10 & 20 (20 pts)..

The PDF file must be E-Mailed to

ContractAdministration@tampagov.net

BEFORE 2 P.M., February

11, 2021. As a courtesy, the City will endeavor provide an email

acknowledgement usually sent within a few days after submission

receipt (submissions received on the day of the deadline may not be

acknowledged before the deadline or at all). It is Firm’s responsibility to

confirm its submission (PDF file) has been received.

* With submittal or within 10 days thereafter, Firm must provide a signed copy of the complete agreement between all JV/PN members indicating

respective roles, responsibilities, and levels of participation.

RFQ TRANSMITTAL MEMORANDUM

FOR A SUBMITTAL TO THE CITY OF TAMPA, FLORIDA

TRANSMITTAL DATE:

RFQ

TITLE

TO:

Brad L. Baird, P. E., Chairman

Selection & Certification

Committee

(CCNA)

c/o Contract Administration Department via ContractAdministration@tampagov.net

306 East Jackson Street, 4th Floor North, Tampa, Florida 33602

SUBMITTER

(“Firm”)

NAME

FEDERAL

TAX

ID#:

FIRM

TYPE:

Individual/Sole Proprietor Joint Venture (JV)* Partnership (PN)* Corporation

Limited Liability Company Other:

FIRM CONTACT NAME:

PHONE

CERTIFICATIONS:

Firm is licensed, permitted, and certified as required to do business in Florida: Yes | No

License/registration/certification no(s):

§287.133

, Fla

Sta

, i

ndividuals or entities

(including

those

meeting the §287.133

, Fla. Stat.

definition of

“affiliate”) placed on the convicted vendor list (“List”) following a conviction for public entity crimes may not

submit a bid, proposal, or reply (“Response”) on a contract to provide any goods or services to a public

entity, may not submit a Response on a contract with a public entity for the repair or construction of a public

building or public work, may not submit a Response for leases of real property to a public entity, and may not be

awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public

entity; and may not transact business with any public entity in excess of the threshold amount provided in

§287.017, Fla. Stat. for CATEGORY TWO for a period of 36 months from the date of placement on the List.

Neither Firm nor its affiliates have been placed on the List: Yes | No

Firm’s

own initial application for employment has criminal history screening practices similar

to th

ose

contained

in Chapter 12, Article VI, Tampa Code (responses, whether “Yes” or “No”, are for informational purposes only

and will not be used as a basis for award or denial, or for any protest): Yes | No

Firm

shall comply with all applicable governmental

rules

regulations

including

the

City's Ethics Code

(

Sec

522, Tampa Code). The City's Charter & Ethics Code prohibit any City employee from receiving any substantial

benefit or profit out of any award or obligation entered into with the City, or from having any direct or indirect

financial interest in effecting any such award or obligation. If Firm is successful, it shall ensure no City employee

receives any such benefit or interest as a result of such award (See Sec.2-514(d),Tampa Code): Yes | No

Firm is

not in arrears

and is

not

in d

efault

upon any obligation to the City

of Tampa

Yes |

Firm agrees that i

f the City

of Tampa

determines

Firm has participated in any collusive, deceptive, or

fraudulent

practices with regard to this submittal, in addition to any other remedy it may exercise, the City will have the

right to debar Firm and deem invalid any contract let under such circumstances: Yes | No

ata or

material

Firm

asserts to be exempted from public disclosure under Chapter

119, Fla

Stat

submitted

in a separate, single electronic searchable PDF file labeled with the above RFQ number and the phrase

“Confidential Material”, which identifies the data/material to be protected, states the reasons the date/material is

exempt from public disclosure, and the specific Florida statute allowing such exemption (if “No” or otherwise,

then Firm waives any possible or claimed exemption upon submission, effective at opening): Yes | No

FAILURE TO COMPLETE THE ABOVE MAY RESULT IN

FIRM

’

SUBMITTAL

BEING DECLARED NON

RESPONSIVE

Authorized Signature (wet):

[SEAL] Printed Name:

Title: Sole Prop Pres Sr VP Gen Ptnr LLC Auth.Mbr/Mgr

Other _______________________ (attach proof of authority)

STATE OF

COUNTY OF

The forgoing instrument was sworn (or affirmed) before me before me by means of ☐ physical presence or ☐ online

notarization, this ____ day of ________________________, 20____ by _________________________________________

either in his/her individual capacity or where Firm is an entity as the ____________________________________ of

__________________________________________, on behalf of such entity. He/She is personally known to me OR

produced identification. Type of identification produced:

[NOTARY SEAL]

Printed Name: Notary Public, State of

My Commission Expires: Commission No:

Rev.2018-09-12

21-D-00016; El Prado Blvd. (Omar to Bayshore Blvd.) Complete Streets and Sidewalk Project Design

Points Pursuant to Designated Industry Category:______________

(Refer to MBD Form 70 and Form 50-GFE Outreach)

Evaluation Criteria

Point Values

Underutilized WMBE Firms participating as the

Prime Contractor (City of Tampa Certified Only)

City of Tampa Certified SLBE firms participating

as the Prime Contractor, which include City of

Tampa Certified WMBE/SLBE sub-(contractor,

consultant) participation

5 - 15

Non-City of Tampa Certified WMBE/SLBE Prime

Contractor with meaningful sub-(contractor,

consultant) participation by City Certified

Underutilized WMBE and/or SLBE firms

1 - 15

* External agency WMBE/SLBE/DBE

certifications recognized by City of Tampa for

designated RFP, RFQ, RFI solicitations

0 – 7

NOTE: The maximum points available for WMBE and/or SLBE participation will not exceed twenty (20)

Points are determined as follows (Requires Form 50-GFE):

A. A maximum of twenty (20) rating points may be awarded when the Proposer is a City of Tampa

Certified WMBE firm deemed underutilized within the Industry category established by the RFQ.

B. A maximum of fifteen (15) rating points may be awarded when the Proposer is a City of Tampa

certified SLBE with meaningful participation by City certified WMBE/SLBE sub-

contractors/consultants.

C. One to Fifteen (1-15) rating points may be awarded when the Proposer is not a City of Tampa

certified WMBE/SLBE prime contractor but utilizes either Underutilized WMBE and/or SLBE

certified firm(s) as sub-contractors/consultants and assigned to perform meaningful segments of

the contractual services detailed herein and documented on the enclosed MBD Form 10-20.

D. A maximum of seven (7) “discretionary” rating points may be awarded when the Proposer

provides WMBE/SLBE participation from an external agency recognized by the City. Discretionary

points may be awarded for ancillary participation (see definition). The point values for ancillary

participation may be subordinate to weighted values outlined in categories A, B and C above.

NOTE: *WMBE participation is narrowly-tailored (per policy) to target underutilization of affected

groups in specific trade/industry categories. Any WMBE/SLBE achievement that was not

designated on MBD Form 70 is considered ancillary. Ancillary participation may be counted with

overall participation and credited to your rating points when underutilization criteria are met.

The maximum number of points available for WMBE and/or SLBE participation will not exceed a total

of twenty (20) points.

MBD Form 50 rev/effective 02/2016 GFECP MBD Form 50 Page 1 of 2

Good Faith Effort Compliance Plan Guidelines

for Women/Minority Business Enterprise\Small Local Business Enterprise Participation

City of Tampa - Equal Business Opportunity Program

(MBD Form 50 – detailed instructions on page 2 of 2)

Contract Name____________________________________________________ Bid Date _________

Bidder/Proposer______________________________________________________________________

Signature ___________________________________________________________ Date __________

Name _______________________________________ Title _________________________________

The Compliance Plan with attachments is a true account of Good Faith Efforts (GFE) made to achieve the participation goals as

specified for Women/Minority Business Enterprises/Small Local Business Enterprises (WMBE/SLBE) on the referenced contract:

□ The WMBE/SLBE participation Goal is Met or Exceeded. See DMI Forms 10 and 20 which accurately report all

subcontractors solicited and all subcontractors to-be-utilized.

---------------------------------------------------------------------------------------------------------------------------------------------------------------------------

□ The WMBE/SLBE participation Goal is Not Achieved. The following list is an overview of the baseline GFE action

steps already performed. Furthermore, it is understood that these GFE requirements are weighted in the compliance

evaluation based on the veracity and demonstrable degree of documentation provided with the bid/proposal:

(Check applicable boxes below. Must enclose supporting documents accordingly with remarks)

(1) Solicited through reasonable and available means the interest of WMBE/SLBEs that have the capability to perform the work of the contract. The Bidder or Proposer must

solicit this interest within sufficient time to allow the WMBE/SLBEs to respond. The Bidder or Proposer must take appropriate steps to follow up initial solicitations with

interested WMBE/SLBEs. □ See DMI report forms for subcontractors solicited. □ See enclosed supplemental data on solicitation

efforts. □ Qualifying Remarks:

(2) Provided interested WMBE/SLBEs with adequate, specific scope information about the plans, specifications, and requirements of the contract, including addenda, in a

timely manner to assist them in responding to the requested-scope identified by bidder/proposer for the solicitation. □ See enclosed actual solicitations

used. □ Qualifying Remarks:

(3) Negotiated in good faith with interested WMBE/SLBEs that have submitted bids (e.g. adjusted quantities or scale). Documentation of negotiation must include the names,

addresses, and telephone numbers of WMBE/SLBEs that were solicited; the date of each such solicitation; a description of the information provided regarding the plans

and specifications for the work selected for subcontracting; and evidence as to why agreements could not be reached with WMBE/SLBEs to perform the work. Additional

costs involved in soliciting and using subcontractors is not a sufficient reason for a bidder/proposer’s failure to meet goals or achieve participation, as long as such costs

are reasonable. Bidders are not required to accept excessive quotes in order to meet the goal.

□ DMI Utilized Forms for sub-(contractor/consultant) reflect genuine negotiations □ This project is an RFQ/RFP in nature

and negotiations are limited to clarifications of scope/specifications and qualifications. □ See enclosed documentation.

□ Qualifying Remarks:

(4) Not rejecting WMBE/SLBEs as being unqualified without justification based on a thorough investigation of their capabilities. The WMBE/SLBEs standing within its industry,

membership in specific groups, organizations / associations and political or social affiliations are not legitimate causes for rejecting or not soliciting bids to meet the goals.

□ Not applicable. □ See attached justification for rejection of a subcontractor’s bid or proposal. □ Qualifying Remarks:

(5) Made scope(s) of work available to WMBE/SLBE subcontractors and suppliers; and, segmented portions of the work or material consistent with the available

WMBE/SLBE subcontractors and suppliers, so as to facilitate meeting the goal. □ Sub-Contractors were allowed to bid on their own choice of

work or trade without restriction to a pre-determined portion. □ See enclosed comments. □ Qualifying Remarks:

(6) Made good faith efforts, despite the ability or desire of Bidder/Proposer to perform the work of a contract with its own forces/organization. A Bidder/Proposer who desires

to self-perform the work of a contract must demonstrate good faith efforts if the goal has not been met. □ Sub-Contractors were not prohibited from

submitting bids/proposals and were solicited on work typically self-performed by the prime. □ Qualifying Remarks:

(7) Segmented portions of the work to be performed by WMBE/SLBEs in order to increase the likelihood that the goals will be met. This includes, where appropriate,

breaking out contract work items into economically feasible units (quantities/scale) to facilitate WMBE/SLBE participation, even when the Bidder/Proposer might otherwise

prefer to perform these work items with its own forces. □ Sub-Contractors were allowed to bid on their own choice of work or trade without

restriction to a pre-determined portion. □ Sub-Contractors were not prohibited from submitting bids/proposals and were

solicited on work typically self-performed by the prime. □ See enclosed comments. □ Qualifying Remarks:

(8) Made efforts to assist interested WMBE/SLBEs in obtaining bonding, lines of credit, or insurance as required by the city or contractor.

□ See enclosed documentation on initiatives undertaken and methods to accomplish. □ Qualifying Remarks:

(9) Made efforts to assist interested WMBE/SLBEs in obtaining necessary equipment, supplies, materials, or related assistance or services, including participation in an

acceptable mentor-protégé program. □ See enclosed documentation of initiatives and/or agreements. □ Qualifying Remarks:

(10) Effectively used the services of the City and other organizations that provide assistance in the recruitment and placement of WMBE/SLBEs.

□ See enclosed documentation. □ The following services were used:

Note: Provide any unsolicited information that will support the Bid/RFP Compliance Evaluation. □ Named Documents Are:

MBD Form 50 rev/effective 02/2016 GFECP MBD Form 50 Page 2 of 2

Participation Plan: Guidance for Complying with Good Faith Efforts Outreach

(page 2 of 2)

1. All firms on the WMBE/SLBE Goal Setting List must be solicited and documentation provided for email,

fax, letters, phone calls, and other methods of outreach/communication with the listed firms. The DMI

Solicited and DMI-Utilized forms must be completed for all firms solicited or utilized. Other opportunities

for subcontracting may be explored by consulting the City of Tampa MBD Office and/or researching the on-

line Diversity Management Business System Directory for Tampa certified WMBE/SLBE firms.

2. Solicitation of WMBE/SLBEs, via written or electronic notification, should provide specific information on

the services needed, where plans can be reviewed and assistance offered in obtaining these, if required.

Solicitations should be sent a minimum of a week (i.e. 5 business days or more) before the bid/proposal date.

Actual copies of the bidder’s solicitation containing their scope specific instructions should be provided.

3. With any quotes received, a follow-up should be made when needed to confirm detail scope of work. For

any WMBE/SLBE low quotes rejected, an explanation Shall be provided detailing negotiation efforts.

4. If a low bid WMBE/SLBE is rejected or deemed unqualified the contractor must provide an explanation and

supporting documentation for this decision.

5. Prime Shall break down portions of work into economical feasible opportunities for subcontracting. The

WMBE/SLBE directory may be useful in identifying additional subcontracting opportunities and firms not

listed in the “WMBE/SLBE Goal Setting Firms List.”

6. Contractor Shall not preclude WMBE/SLBEs from bidding on any part of work, even if the Contractor may

desire to self-perform the work.

7. Contractor Shall avoid relying solely on subcontracting out work-scope where WMBE/SLBE availability is

not sufficient to attain the pre-determined subcontract goal set for the Bid or when targeted sub-consultant

participation is stated within the RFP/RFQ.

8. In its solicitations, the Bidder should offer assistance to WMBE/SLBEs in obtaining bonding, insurance, et

cetera, if required of subcontractors by the City or Prime Contractor.

9. In its solicitation, the Bidder should offer assistance in obtaining equipment for a specific job to

WMBE/SLBEs, if needed.

10. Contractor should use the services offered by such agencies as the City of Tampa Minority and Small

Business Development Office, Hillsborough County Entrepreneur Collaborative Center, Hillsborough

County Economic Development Department’s MBE/SBE Program and the NAACP Empowerment Center to

name a few for the recruitment and placement of WMBEs/SLBEs.

Failure to Complete, Sign and Submit Both Forms 10 & 20 SHALL render the Bid or Proposal Non-Responsive

Page 1 of 4 – DMI Solicited/Utilized Schedules

City of Tampa – Schedule of All Solicited Sub-(Contractors/Consultants/Suppliers)

(FORM MBD-10)

Contract No.: Contract Name:

Company Name: Address:

Federal ID: Phone: Fax: Email:

Check applicable box(es). Detailed Instructions for completing this form are on page 2 of 4.

[ ] No Firms were contacted or solicited for this contract.

[ ] No Firms were contacted because:

[ ] See attached list of additional Firms solicited and all supplemental information (List must comply to this form)

Note: Form MBD-10 must list ALL subcontractors solicited including Non-minority/small businesses

NIGP Code Categories: Buildings = 909, General = 912, Heavy = 913, Trades = 914, Architects = 906, Engineers & Surveyors = 925, Supplier = 912-77

S = SLBE

W=WMBE

O = Neither

Company Name

Address

Phone, Fax, Email

Type of Ownership

(F=Female M=Male)

BF BM = African Am.

HF HM = Hispanic

AF AM = Asian Am.

NF NM = Native Am.

CF CM = Caucasian

Trade or

Services

NIGP Code

(listed

above)

Contact

Method

L=Letter

F=Fax

E=Email

P=Phone

Quote

Response

Received

Y/N

Federal ID

It is hereby certified that the information provided is an accurate and true account of contacts and solicitations for sub–contracting

opportunities on this contract.

Signed: Name/Title: Date:

Failure to Complete, Sign and Submit Both Forms 10 & 20 SHALL render the Bid or Proposal Non-Responsive

Forms must be included with Bid / Proposal

D 10 rev./effective 02/2016

Page 2 of 4 – DMI Solicited/Utilized

Instructions for completing The Sub-(Contractors/Consultants/ Suppliers) Solicited Form

(Form MBD-10)

This form must be submitted with all bids or proposals. All subcontractors (regardless of ownership or size) solicited

and subcontractors from whom unsolicited quotations were received must be included on this form. The instructions that

follow correspond to the headings on the form required to be completed. Note: Ability or desire to self-perform all work

shall not exempt the prime from Good Faith Efforts to achieve participation.

• Contract No. This is the number assigned by the City of Tampa for the bid or proposal.

• Contract Name. This is the name of the contract assigned by the City of Tampa for the bid or proposal.

• Contractor Name. The name of your business and/or doing business as (dba) if applicable.

• Address. The physical address of your business.

• Federal ID. FIN. A number assigned to your business for tax reporting purposes.

• Phone. Telephone number to contact business.

• Fax. Fax number for business.

• Email. Provide email address for electronic correspondence.

• No Firms were contacted or solicited for this contract. Checking the box indicates that a pre-determined

Subcontract Goal or Participation Plan Requirement was not set by the City resulting in your business not using

subcontractors and will self-perform all work. If during the performance of the contract you employ

subcontractors, the City must pre-approve subcontractors. Use of the “Sub-(Contractors/Consultants/Suppliers)

Payments” form (MBD Form-30) must be submitted with every pay application and invoice. Note: Certified

SLBE or WMBE firms bidding as Primes are not exempt from outreach and solicitation of subcontractors.

• No Firms were contacted because. Provide brief explanation why no firms were contacted or solicited.

• See attached documents. Check box, if after you have completed the DMI Form in its entirety, you need more

space to list additional firms and/or if you have supplemental information/documentation relating to the form. All

DMI data not submitted on the MBD Form-10 must be in the same format and have all requested data from MBD

Form-10 included.

The following instructions are for information of any and all subcontractors solicited.

• “S” = SLBE, “W” = WMBE. Enter “S” for firms Certified by the City as Small Local Business Enterprises and/or

“W” for firms Certified by the City as either Women/Minority Business Enterprise; “O” = Non-certified others.

• Federal ID. FIN. A number assigned to a business for tax reporting purposes. This information is critical in proper

identification and payment of the contractor/subcontractor.

• Company Name, Address, Phone & Fax. Provide company information for verification of payments.

• Type of Ownership. Indicate the Ethnicity and Gender of the owner of the subcontracting business.

• Trade, Services, or Materials indicate the trade, service, or materials provided by the subcontractor. NIGP codes

aka “National Institute of Governmental Purchasing” are listed at top section of document.

• Contact Method L=letter, F=fax, E=Email, P=Phone. Indicate with letter the method(s) of soliciting for bid.

• Quote or Resp. (response) Rec’d (received) Y/N. Indicate “Y” Yes if you received a quotation or if you received

a response to your solicitation. Indicate “N” No if you received no response to your solicitation from the

subcontractor. Must keep records: log, ledger, documentation, etc. that can validate/verify.

If additional information is required or you have questions, please contact the Equal Business Opportunity Program -

Minority and Small Business Development Office at (813) 274-5522.

Failure to Complete, Sign and Submit Both Forms 10 & 20 SHALL render the Bid or Proposal Non-Responsive

Page 3 of 4 – DMI Solicited/Utilized Schedules

City of Tampa – Schedule of All To-Be-Utilized Sub-(Contractors/Consultants/Suppliers)

(FORM MBD-20)

Contract No.: Contract Name:

Company Name: Address:

Federal ID: Phone: Fax: Email:

Check applicable box(es). Detailed Instructions for completing this form are on page 4 of 4.

[ ] See attached list of additional Firms Utilized and all supplemental information (List must comply to this form)

Note: Form MBD-20 must list ALL subcontractors To-Be-Utilized including Non-minority/small businesses

[ ] No Subcontracting/consulting (of any kind) will be performed on this contract.

[ ] No Firms are listed to be utilized because:

NIGP Code General Categories: Buildings = 909, General = 912, Heavy = 913, Trades = 914, Architects = 906, Engineers & Surveyors = 925, Supplier = 912-77

Enter “S” for firms Certified as Small Local Business Enterprises, “W” for firms Certified as Women/Minority Business Enterprise, “O” for Other Non-Certified

S = SLBE

W=WMBE

O =Neither

Company Name

Address

Phone, Fax, Email

Type of Ownership

(F=Female M=Male)

BF BM = African Am.

HF HM = Hispanic Am.

AF AM = Asian Am.

NF NM = Native Am.

CF CM = Caucasian

Trade,

Services,

or Materials

NIGP Code

Listed

above

$ Amount

of Quote.

Letter of

Intent (LOI)

if available

Percent

Scope or

Contract

Federal ID

Total ALL Subcontract / Supplier Utilization $____________________

Total SLBE Utilization $ _____________________________________

Total WMBE Utilization $ ____________________________________

Percent SLBE Utilization of Total Bid/Proposal Amt. _____% Percent WMBE Utilization of Total Bid/Proposal Amt. _____%

It is hereby certified that the following information is a true and accurate account of utilization for sub-contracting opportunities on this Contract.

Signed: Name/Title: Date:

Failure to Complete, Sign and Submit Both Forms 10 & 20 SHALL render the Bid or Proposal Non-Responsive

Forms must be included with Bid / Proposal

MBD 20 rev./effective 02/2016

Page 4 of 4 DMI – Solicited/Utilized

Instructions for completing The Sub-(Contractors/Consultants/ Suppliers) to be Utilized Form

(Form MBD-20)

This form must be submitted with all bids or proposals. All subcontractors (regardless of ownership or size) projected

to be utilized must be included on this form. Note: Ability or desire to self-perform all work shall not exempt the prime

from Good Faith Efforts to achieve participation.

Contract No. This is the number assigned by the City of Tampa for the bid or proposal.

• Contract Name. This is the name of the contract assigned by the City of Tampa for the bid or proposal.

• Contractor Name. The name of your business and/or doing business as (dba) if applicable.

• Address. The physical address of your business.

• Federal ID. FIN. A number assigned to your business for tax reporting purposes.

• Phone. Telephone number to contact business.

• Fax. Fax number for business.

• Email. Provide email address for electronic correspondence.

• No Subcontracting/consulting (of any kind) will be performed on this contract. Checking box indicates your

business will not use subcontractors when no Subcontract Goal or Participation Plan Requirement was set by the

City, but will self-perform all work. When subcontractors are utilized during the performance of the contract, the

“Sub-(Contractors/Consultants/Suppliers) Payments” form (MBD Form-30) must be submitted with every pa

pplication and invoice. Note: certified SLBE or WMBE firms bidding as Primes are not exempt from outreach

and solicitation of subcontractors, including completion and submitting Form-10 and Form-20.

• No Firms listed To-Be-Utilized. Check box; provide brief explanation why no firms were retained when a goal

or participation plan requirement was set on the contract. Note: mandatory compliance with Good Faith Effort

outreach (GFECP) requirements applies (MBD Form-50) and supporting documentation must accompany the bid.

• See attached documents. Check box, if after completing the DMI Form in its entirety, you need more space to

list additional firms and/or if you have supplemental information/documentation relating to the

scope/value/percent utilization of subcontractors. Reproduce copies of MBD-20 and attach. All data not

submitted on duplicate forms must be in the same format and content as specified in these instructions.

The following instructions are for information of Any and All subcontractors To Be Utilized.

• Federal ID. FIN. A number assigned to a business for tax reporting purposes. This information is critical in

proper identification of the subcontractor.

• “S” = SLBE, “W” = WMBE. Enter “S” for firms Certified by the City as Small Local Business Enterpris

nd/or “W” for firms Certified by the City as Women/Minority Business Enterprise; “O” = Non-certified others.

• Company Name, Address, Phone & Fax. Provide company information for verification of payments.

• Type of Ownership. Indicate the Ethnicity and Gender of the owner of the subcontracting business.

• Trade, Services, or Materials (NIGP code if Known) Indicate the trade, service, or material provided by the

subcontractor. Abbreviated list of NIGP is available at http:/www.tampagov.net/mbd “Information Resources”

• Amount of Quote, Letters of Intent (required for both SLBEs and WMBEs).

• Percent of Work/Contract. Indicate the percent of the total contract price the subcontract(s) represent. Fo

CNA only (i.e. Consultant A/E Services) you must indicate subcontracts as percent of total scope/contract.

• Total Subcontract/Supplier Utilization. – Provide total dollar amount of all subcontractors/suppliers projected

to be used for the contract. (Dollar amounts may be optional in CCNA depending on solicitation format).

• Total SLBE Utilization. Provide total dollar amount for all projected SLBE subcontractors/Suppliers used for

this contract. (Dollar amounts may be optional in CCNA proposals depending on the solicitation format).

• Total WMBE Utilization. Provide total dollar amount for all projected WMBE subcontractors/Suppliers used for

this contract. (Dollar amounts may be optional in CCNA proposals depending on the solicitation format).

• Percent SLBE Utilization. Total amount allocated to SLBEs divided by the total bid/proposal amount

• Percent WMBE Utilization. Total amount allocated to WMBEs divided by the total bid/proposal amount.

If additional information is required or you have questions, please contact the Equal Business Opportunity Program -

Minority and Small Business Development Office at (813) 274-5522.

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Page 1 o

Procurement Guidelines

To Implement

Minority & Small Business Participation

Underutilized WMBE Primes by Industry Category

Construction

Construction‐

Professional Non‐Professional Goods

AL PROCUREMENT

Black Asian Black Black Black

Hispanic Native Am. Hispanic Asian Hispanic

Native Am.

Woman

Asian Native Am. Asian

FORM

Woman

Native Am. Native Am.

Woman Woman

Underutilized WMBE Sub‐Contractors / Sub‐Consultants

Construction

Construction‐

Professional Non‐Professional Goods

Black Black Black Black Black

Asian Hispanic Asian Asian

SUB WORK

Native Am.

Asian Native Am. Native Am.

Woman Native Am.

Woman

Policy

The Guidelines apply to formal procurements and solicitations. WMBE participation will be narrowly‐tailored.

Index

▪ Black = Black/African‐American Business Enterprise

▪ Hispanic = Hispanic Business Enterprise

▪ Asian = Asian Business Enterprise

▪

Native Am. = Native American Business Enterprise

▪

Woman = Woman Business Enterprise (Caucasian)

Industry Categories

Construction is defined as: new construction, renovation, restoration, maintenance of public improvements and underground utilities.

Construction‐Related Services are defined as: architecture, professional engineering, landscape architecture, design build, construction

management services, or registered surveying and mapping.

Professional Services

are defined as: attorney, accountant, medical doctor, veterinarian, miscellaneous consultant, etc.

Non‐Professional Services are defined as: lawn maintenance, painting, janitorial, printing, hauling, security guard, etc.

Goods are defined as: all supplies, materials, pipes, equipment, machinery, appliances, and other commodities.

MBD Form‐70

October 2012 (RFP)

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