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Form 103 – MWBE Utilization Plan . The Bidder/Applicant must submit a s eparate M/WBE Notice of Intent to Participate form for each MBE or WBE as part of the proposal/application. ����g�������� ��M�I_������YU�[(�yq��Yrx���o��.�l�-�z����oŋkx�v��z�����B�� endobj M/WBE CONTRACTOR GOOD FAITH EFFORTS CERTIFICATION (FORM 105) PROJECT/CONTRACT # 12. If ‘Yes’, please list other location(s) by city and state: Yes No 25.
<> Does your Business operate at more than one (1) location? 2375 0 obj <>stream Able Transportation's MWBE Form 103 - Good Faith Efforts 3. ?4䯆�Ԑ��CK~h�����. §102-12 DBE/MBE/WBE/SDVOB PARTICIPATION December 2019 New York State Department of Transportation Page 2 Contract Administration Manual . prepared by (signature): date: endobj Yes No 23. �[��hR&6�K*q�!��%�&� 6qy����^(�%�x�4�����Oe���U"Ʌ�V%�\�Ъ��x��r/Qe3 ����(�AѸ��C�GNy"D�qj:������H$I�p��?
Service-Disabled Veteran-Owned Businesses (SDVOBs) certified by the Office of General ���`���������������������$:pt�(˂K@Z���N:.�!샨�kn����0;p�3,g_����eC����?���Z�20'�1�8�o���bpsX� ����M ��g0�V``�����o��/��!��2F'� ! 3 0 obj endstream endobj startxref
1535 0 obj <> endobj stream Type of Form Full Participation Request Partial Waiver Request Total Waiver Calculation of M/WBE Goal Amount M/WBE Cover Letter M/WBE 100 Utilization Plan N/A M/WBE 102 Notice of Intent to Participate N/A M/WBE 105 ontractor’s Good Faith Efforts N/A M/WBE 101 Request for Waiver Form …
Is your Business registered with the Kentucky Secretary of State’s Office? Form MWBE_1 Rev.
%PDF-1.5 1572 0 obj <>stream 13. 1. Group 73012 – Hourly Based IT Services (HBITS) (Statewide) RFP Number: 23158 Bid Opening: March 05, 2019 at 11:00 a.m. EST MBE/WBE Reporting. D. Form 102 - Workforce Employment Utilization Report (“Workforce Report”) 1. endobj ____MBE Subcontractor ____WBE Subcontractor ____ ____WBE Supplier AR ___ ____ M/WBE SUBCONTRACTORS AND SUPPLIERS NOTICE OF INTENT TO PARTICIPATE .
Type of Form Full Participation Request Partial Waiver Request Total Waiver M/WBE Cover Letter M/WBE 100 Utilization Plan N/A M/WBE 102 Notice of Intent to Participate N/A EEO 100 Staffing Plan and Instructions M/WBE 105 Contractor’s Good Faith Efforts N/A M/WBE 101 Request for Waiver Form … %PDF-1.6 %���� 1. 1557 0 obj <>/Filter/FlateDecode/ID[<4FE1D6417DAF644DB8B0325DB4810484><806554066B353547B4C437696931D169>]/Index[1535 38]/Info 1534 0 R/Length 111/Prev 372082/Root 1536 0 R/Size 1573/Type/XRef/W[1 3 1]>>stream <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 17 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> INSTRUCTIONS: Part A of this form must be completed and signed by the Bidder/Applicant unless requesting a total waiver . h�bbd```b``������T�vL��,� ��?��V/&��"�`�nɤ"���"@d�$0[H2�~���� I�� ��.������$��j��? Only . :D 24. Able Transportation's MWBE Form 102 - Application for Waiver/Explanation 2. Recipients must complete EPA Form 5700-52A to report MBE/WBE utilization under EPA assistance agreements when the combined total of funds budgeted for procuring supplies, equipment, construction or services exceeds the Simplified Acquisition Threshold. mwbe form 107 7. nys esd certified mbe wbe 8. nys esd certified mbe wbe 9. nys esd certified mbe wbe 6. if unable to fully meet the mbe and wbe goals set forth in the contract, offeror must submit a request for waiver form (m/wbe 104).
C. SDVOB Certification . Submit completed form to: NYS Office for the Aging, 2 ESP, Albany, NY 12223-1251. 1 0 obj Once a contract has been awarded and during the term of Contract, Contractor is responsible for updating and providing notice to the Department of any changes to the previously ... A.
02/19/2019 - - 2 22. MWBE 102 (Revised 9/12) General Instructions: The work force utilization (MWBE.
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endstream endobj 1536 0 obj <. Annual reports are due by October 30 th of each year. v 57��9RK.,�u\�J)�u���"�I�CDux����yq�@ |�1%���Qw���a����V�7�BM=(��cb���X���X��R�Iop�D`�K�ɧ hb���\=����x��K�-6 ����YG��Ő��R��"g�f���� $גi�(�6�O$����`�g���a�1J��� =�ҍ}M��E��|d#�dBqk}(q@8l����lHCFB΅�D�A��"(��Z�4�m��c�d8����O�]�_�}��⚞������4�EM���̮R�BX����K�qmY^�o�����N�S��\DGX�3��5�. ... M/WBE 102 . Any other documents that may be helpful in the review of this waiver Able Transportation's EEO Form 100.
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