HomeMy WebLinkAboutResolution 2022-095 N.C.S. 06/06/2022 DocuSign Envelope ID:AE38B657-EABC-4ADB-9476-5EF6DFF40078
Resolution No. 2022-095 N.C.S.
of the City of Petaluma, California
ADOPTING THE DISADVANTAGED BUSINESS ENTERPRISE PROGRAM FOR THE YEAR 2022
FOR FEDERAL AVIATION ADMINISTRATION FUNDED PROJECTS
WHEREAS,the City of Petaluma Municipal Airport located at 601 Sky Ranch Dr. serves as the only public
airport for Petaluma including sales of fuel and general aviation operations and hangar rentals; and
WHEREAS, in order to be eligible to apply for federal grant funding through the ACIP program, grantees
must comply with defined federal funding rules and regulations as outlined in Title 49 of the Code of Federal
Regulations Part 26 (49 CFR Part 26); and
WHEREAS, on February 20, 2001, the City of Petaluma adopted a city-wide Disadvantaged Business
Enterprise (DBE)program to be in compliance with federal funding requirements; and
WHEREAS, City staff, in conjunction with their consultant, Mead & Hunt, have prepared an updated
Disadvantaged Business Enterprise Program, Exhibit A; and
WHEREAS, this resolution does not constitute a "project" within the meaning of Section 15378 of the
California Environmental Quality Act Guidelines,because it is an administrative activity that has no potential for
resulting in a physical change in the environment as the resolution creates a program for disadvantage businesses
to participate in bids and does not itself encourage physical development; and
WHEREAS, the City Council has reviewed the staff report and considered the testimony and evidence at a
regular meeting on June 6, 2022.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Petaluma hereby:
1. Declares that the above recitals are to be true and correct and are incorporated into this resolution as findings
of the City Council.
2. Finds that this resolution does not constitute a"project"within the meaning of Section 15378 of the California
Environmental Quality Act Guidelines, because it is an administrative activity that has no potential for
resulting in a physical change in the environment as the resolution creates a program for disadvantage
businesses to participate in bids and does not itself encourage physical development.
3. Adopts the proposed DBE Program, as described in Exhibit A.
4. The City's previous DBE Program adopted on February 20, 2021, is hereby repealed, and replaced with the
proposed DBE Program, as described in Exhibit A.
5. Authorizes and directs the City Clerk to publish a notice regarding the DBE Program in both minority and
majority media and any additional notice that the City Clerk or her designee sees fit.
Resolution No. 2022-095 N.C.S. Page 1
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Under the power and authority conferred upon this Council by the Charter of said City.
REFERENCE: I hereby certify the foregoing Resolution was introduced and adopted by the Approved as to
Council of the City of Petaluma at a Regular meeting on the 6'day of June 2022, DocuSigned :
by the following vote:
5EF85A€1{ F3048orhey
AYES: Mayor Barrett,Vice Mayor Pocekay,Barnacle,Fischer,Healy,King,McDonnell 11 ``yy EE11TrCC
NOES: None
ABSENT: None
ABSTAIN: None
DocuSigned by: DocuSigned�Q YL1lby:
fit,
ATTEST: 'K,� sa' IJa ll
City Clerk Maybf-2E6B48F42E...
Resolution No. 2022-095 N.C.S. Page 2
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EXHIBIT A
DEPARTMENT OF TRANSPORTATION
DBE PROGRAM —49 CFR PART 26
PETALUMA
SONOMA COUNT,,
Petaluma Municipal Airport (069)
Prepared for
City of Petaluma
Petaluma, CA
Prepared by
Mead
11 lunt
May 13, 2022
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TABLE OF CONTENTS
Page
Preface...I
Policy Statement...2
Subpart A—General Requirements...3
Subpart B—Administrative Requirements...5
Subpart C—Goals, Good Faith Efforts, and Counting...12
Subpart D—Certification Standards...21
Subpart E—Certification Procedures...22
Subpart F—Compliance & Enforcement...22
List of Attachments...24
Petaluma Municipal Airport(069) TOC i 49 CFR Part 26 Program
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Preface
The City of Petaluma, California is the owner and operator of the Petaluma Municipal
Airport (069). The City controls, operates, and manages all airport operations. It
establishes policy to ensure that quality aviation related services are provided to the
region. The City has established the following Disadvantaged Business Enterprise
(DBE) program for the Petaluma Municipal Airport in accordance with Code of Federal
Regulations (CFR) of the U. S. Department of Transportation (DOT), 49 CFR Part 26.
All reference to Subparts and Section numbers throughout this DBE policy (i.e. Subpart
A, 26.1, 26.3, etc.) are to the 49 CFR Part 26 regulations.
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POLICY STATEMENT
Section 26.1, 26.23 Objectives/Policy Statement
City of Petaluma, owner of Petaluma Municipal Airport (069), has established a
Disadvantaged Business Enterprise (DBE) Program in accordance with regulations of
the U.S. Department of Transportation (DOT), 49 CFR Part 26. CITY OF PETALUMA
has received Federal financial assistance from the Department of Transportation, and
as a condition of receiving this assistance, CITY OF PETALUMA has signed an
assurance that it will comply with 49 CFR Part 26 (hereafter referred to as "Part 26").
It is the policy of the CITY OF PETALUMA to ensure that DBEs as defined in Part 26,
have an equal opportunity to receive and participate in DOT—assisted contracts. It is
also CITY OF PETALUMA policy to engage in the following actions on a continuing
basis:
1. Ensure nondiscrimination in the award and administration of DOT- assisted
contracts;
2. Create a level playing field on which DBEs can compete fairly for DOT-
assisted contracts;
3. Ensure that the DBE Program is narrowly tailored in accordance with
applicable law;
4. Ensure that only firms that fully meet 49 CFR Part 26 eligibility standards are
permitted to participate as DBEs;
5. Help remove barriers to the participation of DBEs in DOT assisted contracts;
6. Promote the use of DBEs in all types of federally-assisted contracts and
procurement activities;
7. Assist the development of firms that can compete successfully in the market
place outside the DBE Program; and
8. Make appropriate use of the flexibility afforded to recipients of Federal
financial assistance in establishing and providing opportunities for DBEs.
The Engineering Manager has been delegated as the DBE Liaison Officer. In that
capacity, Capital Improvement Program Manager is responsible for implementing all
aspects of the DBE program. Implementation of the DBE program is accorded the same
priority as compliance with all other legal obligations incurred by the CITY OF
PETALUMA in its financial assistance agreements with the Department of
Transportation.
CITY OF PETALUMA has disseminated this policy statement to the City of Petaluma
and all of the components of our organization. This statement has been distributed to
DBE and non-DBE business communities that may perform work on CITY OF
PETALUMA DOT-assisted contracts. The Policy Statement is available for public
access on CITY OF PETALUMA 's website (https://cityofpetaluma.org).
Teresa Barrett, Mayor Date
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GENERAL REQUIREMENTS
Section 26.1 Objectives
The objectives are elaborated in the policy statement on the first page of this program.
Section 26.3 Applicability
CITY OF PETALUMA is the recipient of Federal airport funds authorized by 49 U.S.C.
47101, et seq.
Section 26.5 Definitions
CITY OF PETALUMA will use terms in this program that have their meanings defined
in Part 26, §26.5.
Section 26.7 Non-discrimination Requirements
CITY OF PETALUMA will never exclude any person from participation in, deny any
person the benefits of, or otherwise discriminate against anyone in connection with the
award and performance of any contract covered by 49 CFR Part 26 on the basis of
race, color, sex, or national origin.
In administering its DBE program, CITY OF PETALUMA will not, directly or through
contractual or other arrangements, use criteria or methods of administration that have
the effect of defeating or substantially impairing accomplishment of the objectives of the
DBE program with respect to individuals of a particular race, color, sex, or national
origin.
Section 26.11 Record Keeping Requirements
Reporting to DOT
CITY OF PETALUMA will provide data about its DBE Program to the Department as
directed by DOT operating administrations.
DBE participation will be reported to Federal Aviation Administration as follows:
CITY OF PETALUMA will transmit to Federal Aviation Administration annually, by
or before December 1, the information required for the "Uniform Report of DBE
Awards or Commitments and Payments", as described in Appendix B to Part 26.
CITY OF PETALUMA will similarly report the required information about
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participating DBE firms. All reporting will be done through the Federal Aviation
Administration official reporting system, or another format acceptable to Federal
Aviation Administration as instructed thereby.
Bidders List
CITY OF PETALUMA will create and maintain a bidders list. The purpose of the list is
to provide as accurate data as possible about the universe of DBE and non-DBE
contractors and subcontractors who seek to work on CITY OF PETALUMA DOT-
assisted contracts, for use in helping to set overall goals. The bidders list will include the
name, address, DBE and non-DBE status, age of firm, and annual gross receipts of
firms.
This information will be collected using the form in Attachment 3 which will be included
in bidding documents. The information will be submitted by primes and subcontractors
whether or not they were successful in be awarded a subcontract or the prime contract.
CITY OF PETALUMA will provide this information in the public domain.
Records retention and reporting:
CITY OF PETALUMA, as a member of the California UCP established pursuant to
§26.81, will report to the Department of Transportation's Office of Civil Rights each year
the percentage and location in the State of certified DBE firms in the UCP Directory
controlled by the following:
1) Women;
2) Socially and economically disadvantaged individuals (other than women); and
3) Individuals who are women and are otherwise socially and economically
disadvantaged individuals.
Section 26.13 Federal Financial Assistance Agreement
CITY OF PETALUMA has signed the following assurances, applicable to all DOT-
assisted contracts and their administration:
Assurance: - Each financial assistance agreement CITY OF PETALUMA signs with a
DOT operating administration (or a primary recipient) will include the following
assurance:
[Note: The following language is to be used verbatim, as stated in 26.13(a)]
The CITY OF PETALUMA shall not discriminate on the basis of race, color,
national origin, or sex in the award and performance of any DOT-assisted
contract or in the administration of its DBE program or the requirements of 49
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CFR Part 26. The CITY OF PETALUMA shall take all necessary and
reasonable steps under 49 CFR Part 26 to ensure nondiscrimination in the award
and administration of DOT-assisted contracts. The CITY OF PETALUMA DBE
program, as required by 49 CFR Part 26 and as approved by DOT, is
incorporated by reference in this agreement. Implementation of this program is a
legal obligation and failure to carry out its terms shall be treated as a violation of
this agreement. Upon notification to the CITY OF PETALUMA of its failure to
carry out its approved program, the Department may impose sanctions as
provided for under 49 CFR Part 26 and may, in appropriate cases, refer the
matter for enforcement under 18 U.S.C. 1001 and/or the Program Fraud Civil
Remedies Act of 1986 (31 U.S.C. 3801 et seq.).
Contract Assurance: CITY OF PETALUMA will ensure that the following clause is
included in each DOT-funded contract it signs with a contractor (and each subcontract
the prime contractor signs with a subcontractor):
[Note: The following language is to be used verbatim, as stated in 26.13(b)]
The contractor, sub recipient or subcontractor shall not discriminate on the basis of
race, color, national origin, or sex in the performance of this contract. The contractor
shall carry out applicable requirements of 49 CFR part 26 in the award and
administration of DOT-assisted contracts. Failure by the contractor to carry out these
requirements is a material breach of this contract, which may result in the termination of
this contract or such other remedy as the recipient deems appropriate, which may
include, but is not limited to:
1) Withholding monthly progress payments;
2) Assessing sanctions;
3) Liquidated damages; and/or
4) Disqualifying the contractor from future bidding as non-responsible.
SUBPART B -ADMINISTRATIVE REQUIREMENTS
Section 26.21 DBE Program Updates
CITY OF PETALUMA is required to have a DBE program meeting the requirements of
this part as it will receive grants for airport planning or development and will award
prime contracts, cumulative total value of which exceeds $250,000 in FAA funds in a
federal fiscal year. CITY OF PETALUMA is not eligible to receive DOT financial
assistance unless DOT has approved this DBE program and CITY OF PETALUMA is
in compliance with it and Part 26. CITY OF PETALUMA will continue to carry out this
program until all funds from DOT financial assistance have been expended. CITY OF
PETALUMA does not have to submit regular updates of the DBE program document,
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as long as it remains in compliance. However, significant changes in the program,
including those required by regulatory updates, will be submitted for DOT approval.
Section 26.23 Policy Statement
The Policy Statement is elaborated on the first page of this DBE Program.
Section 26.25 DBE Liaison Officer (DBELO)
The following individual has been designated as the DBE Liaison Officer for CITY OF
PETALUMA:
Engineering Manager
11 English Street
Petaluma, CA 94952
Phone: 707.778.4303
email: publicworks@cityofpetaluma.org
Hours: 8:OOAM — 5:00 PM
Monday - Thursday
In that capacity, the DBELO is responsible for implementing all aspects of the DBE
program and ensuring that the CITY OF PETALUMA complies with all provision of 49
CFR Part 26. The DBELO has direct, independent access to the City Manager
concerning DBE program matters. An organizational chart displaying the DBELO's
position in the organization is included in Attachment 2 to this program.
The DBELO is responsible for developing, implementing and monitoring the DBE
program, in coordination with other appropriate officials. The DBELO has a staff of five
to assist in the administration of the program. The duties and responsibilities include
the following:
1. Gathers and reports statistical data and other information as required by
DOT.
2. Reviews third party contracts and purchase requisitions for compliance with
this program.
3. Works with all departments to set overall annual goals.
4. Ensures that bid notices and requests for proposals are available to DBEs in
a timely manner.
5. Identifies contracts and procurements so that DBE goals are included in
solicitations (both race-neutral methods and contract specific goals) and
monitors results.
6. Analyzes CITY OF PETALUMA's progress toward attainment and identifies
ways to improve progress.
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7. Participates in pre-bid meetings.
8. Advises the CEO/governing body on DBE matters and achievement.
9. Chairs the DBE Advisory Committee.
10.Determine contractor compliance with good faith efforts.
11.Provides DBEs with information and assistance in preparing bids, obtaining
bonding and insurance.
12.Plans and participates in DBE training seminars.
13.Provides outreach to DBEs and community organizations to advise them of
opportunities.
Section 26.27 DBE Financial Institutions
It is the policy of the CITY OF PETALUMA to investigate the full extent of services
offered by financial institutions owned and controlled by socially and economically
disadvantaged individuals in the community, to make reasonable efforts to use these
institutions, and to encourage prime contractors on DOT-assisted contracts to make
use of these institutions.
The CITY OF PETALUMA shall use the State of California, Department of General
Services online directory https://ucp.dot.ca.gov/licenseForm.htm to search for
commercial banking, credit unions, and consumer lending businesses. This will be
done on an annual basis at a minimum.
Section 26.29 Prompt Payment Mechanisms
CITY OF PETALUMA requires that all subcontractors performing work on DOT-
assisted contracts shall be promptly paid for work performed pursuant to their
agreements, in accordance with all relevant federal, state, and local law.
In accordance with 49 CFR §26.29, the CITY OF PETALUMA established a contract
clause implementing this requirement and requires prime contractors to pay
subcontractors for satisfactory performance of their contracts no later than 30 days from
the prime contractor's receipt of each payment from the CITY OF PETALUMA.
CITY OF PETALUMA ensures prompt and full payment of retainage from the prime
contractor to the subcontractor within 30 days after the subcontractor's work is
satisfactorily completed. Pursuant to §26.29, CITY OF PETALUMA has selected the
following method to comply with this requirement:
CITY OF PETALUMA will hold retainage from prime contractors and provide for
prompt and regular incremental acceptances of portions of the prime contract, pay
retainage to prime contractors based on these acceptances, and require a contract
clause obligating the prime contractor to pay all retainage owed to the subcontractor for
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satisfactory completion of the accepted work within 30 days after your payment to the
prime contractor.
Additionally, for Federal Aviation Administration (FAA) Recipients include
the following:
To implement this measure, CITY OF PETALUMA includes the following clause
from FAA Advisory Circular 150/5370-10 and City Charter Section 67 in each
DOT-assisted prime construction contract:
a. From the total of the amount determined to be payable on a partial
payment, 10% percent of such total amount will be deducted and
retained by the Owner for protection of the Owner's interests. Unless
otherwise instructed by the Owner, the amount retained by the Owner
will be in effect until the final payment is made.
Any contract may provide for progressive payments, if in the ordinance
authorizing or ordering the work permission is given for such a
contract. But no progressive payments can be provided for or made at
any time which, with prior payments, if there have been such, shall
exceed in amount at that time ninety percent of the value of the labor
done and the materials used up to that time, and no contract shall
provide for or authorize or permit the payment of more than ninety
percent of the contract price before the completion of the work done
under said contract and the acceptance thereof by the proper officer,
department or board.
b. The Contractor is required to pay all subcontractors for satisfactory
performance of their contracts no later than 30 days after the
Contractor has received a partial payment. Contractor must provide the
Owner evidence of prompt and full payment of retainage held by the
prime Contractor to the subcontractor within 30 days after the
subcontractor's work is satisfactorily completed. A subcontractor's
work is satisfactorily completed when all the tasks called for in the
subcontract have been accomplished and documented as required by
the Owner. When the Owner has made an incremental acceptance of
a portion of a prime contract, the work of a subcontractor covered by
that acceptance is deemed to be satisfactorily completed.
c. When at least 95% of the work has been completed to the
satisfaction of the RPR, the RPR shall, at the Owner's discretion and
with the consent of the surety, prepare estimates of both the contract
value and the cost of the remaining work to be done. The Owner may
retain an amount not less than twice the contract value or estimated
cost, whichever is greater, of the work remaining to be done. The
remainder, less all previous payments and deductions, will then be
certified for payment to the Contractor.
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Section 26.31 Directory
CITY OF PETALUMA is a non-certifying member of the California Unified Certification
Program (UCP). The UCP maintains a directory identifying all firms eligible to participate
as DBEs, which contains all the elements required by §26.31.
Section 26.33 Over-concentration
CITY OF PETALUMA has not identified that over-concentration exists in the types of
work that DBEs perform.
Section 26.35 Business Development Programs
CITY OF PETALUMA has a DBE Business Development Program (BDP) to assist
firms in gaining the ability to compete successfully in the marketplace outside the DBE
Program. The CITY OF PETALUMA actively participates with professional
associations, industry organizations, and chambers of commerce. Project contracting
opportunities are listed on the Airport's website as well as other sites that can be found
on the world wide web. Additionally, the CITY OF PETALUMA is a non-certifying
member of the California Unified Certification Program which also provides
opportunities for business development. Interested persons can find more information
through the CITY OF PETALUMA website htti)s://cityofi)etaluma.org.
Section 26.37 Monitoring Responsibilities
CITY OF PETALUMA implements and carries out appropriate mechanisms to ensure
compliance with 49 CFR Part 26 program requirements by all program participants,
including prompt payment, and describes and set forth these mechanisms in CITY OF
PETALUMA 's DBE program.
CITY OF PETALUMA actively monitors participation by maintaining a running tally of
actual DBE attainments (e.g., payments actually made to DBE firms), including a means
of comparing these attainments to commitments.
Monitoring Payments to DBEs and Non-DBEs
CITY OF PETALUMA undertakes ongoing monitoring of prime payments to
subcontractors over the course of any covered contract. Such monitoring activities will
be accomplished through the following method(s):
1. Announcing prime contractor payments at regularly scheduled progress
meetings.
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2. Posting payments to a website, database, or other place accessible to
subcontractors.
CITY OF PETALUMA requires prime contractors to maintain records and documents of
payments to subcontractors, including DBEs, for a minimum of three (3) years unless
otherwise provided by applicable record retention requirements for the CITY OF
PETALUMA's financial assistance agreement, whichever is longer. These records will
be made available for inspection upon request by any authorized representative of CITY
OF PETALUMA or DOT. This reporting requirement extends to all subcontractors,
both DBE and non-DBE.
• CITY OF PETALUMA proactively reviews contract payments to subcontractors
including DBEs on a quarterly basis. Payment reviews will evaluate whether the
actual amount paid to DBE subcontractors is equivalent to the amounts reported
to CITY OF PETALUMA by the prime contractor.
Prompt Payment Dispute Resolution
CITY OF PETALUMA will take the following steps to resolve disputes as to whether
work has been satisfactorily completed for purposes of §26.29.
Meetings will be conducted including CITY OF PETALUMA, prime,
subconsultant, and the resident project representative (RPR) and/or project
manager (PM) presence as appropriate. The purpose of meeting will be to
discuss satisfactory completion requirements and dispute resolution.
CITY OF PETALUMA has established, as part of its DBE program, the following
mechanism(s) to ensure prompt payment and return of retainage:
(1) When the work on which the claim for payment and/or retainage release is
based has been completed, the Subcontractor shall, within 10 calendar days
after not being paid as per the prompt payment clause listed in the Contract,
submit a written claim to the Resident Project Representative (RPR) or Project
Manager (PM) who will present it to CITY OF PETALUMA for consideration in
accordance with contract requirements or local laws / ordinances. The CITY OF
PETALUMA will immediately contact the Prime and require their compliance
with Contract specifications. The matter will be monitored until payment has been
satisfied.
Prompt Payment Complaints
Complaints by subcontractors regarding the prompt payment requirements are handled
according to the following procedure:
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1. The affected contractor shall notify the Project Manager (PM) and/or Resident
Representative (RPR) in writing within 10 days of non-payment. The PM or RPR
shall contact the prime to inquire and resolve the issue.
2. If the affected contractor is not satisfied within 30 days of non-payment they shall
notify the DBELO in writing clearly defining the issue including the dates of non-
payment.
3. If the affected contractor is not satisfied within 90 days of the complaint, they
shall notify the FAA Office of Civil Rights.
Pursuant to Sec. 157 of the FAA Reauthorization Act of 2018, all complaints related to
prompt payment will be reported in a format acceptable to the FAA, including the nature
and origin of the complaint and its resolution.
Enforcement Actions for Noncompliance of Participants
CITY OF PETALUMA will provide appropriate means to enforce the requirements of
§26.29. These means include:
1. We will bring to the attention of the Department of Transportation (DOT) any
false, fraudulent, or dishonest conduct in connection with the program, so that
DOT can take the steps (e.g., referral to the Department of Justice for criminal
prosecution, referral to the DOT Inspector General, action under suspension and
debarment or Program Fraud and Civil Penalties rules) provided in 26.107.
2. Advise subcontractors of the availability of the payment and performance
bond to assure payment for labor and materials in the execution of the
work provided for in the contract
3. Issue a stop-work order until payments are released to subcontractors,
specifying in the contract that such orders constitute unauthorized delays
for the purposes of calculating liquidated damages if milestones are not
met
4. Other penalties for failure to comply, up to and including contract
termination.
CITY OF PETALUMA will actively implement the enforcement actions detailed above.
Monitoring Contracts and Work Sites
CITY OF PETALUMA reviews contracting records and engages in active monitoring of
work sites to ensure that work committed to DBEs at contract award or subsequently
(e.g., as the result of modification to the contract) is actually performed by the DBEs to
which the work was committed. Work site monitoring is performed by DBELO and with
the assistance of the Project Consultant. Contracting records are reviewed by DBELO
and with the assistance of the Project Consultant. CITY OF PETALUMA will maintain
written certification that contracting records have been reviewed and work sites have
been monitored for this purpose.
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Section 26.39 Fostering small business participation
CITY OF PETALUMA has created a Small Business element to structure contracting
requirements to facilitate competition by small business concerns, taking all reasonable
steps to eliminate obstacles to their participation, including unnecessary and unjustified
bundling of contract requirements that may preclude small business participation in
procurements as prime contractors or subcontractors.
The small business element is incorporated as Attachment 10 to this DBE Program.
The program elements will be actively implemented to foster small business
participation.
SUBPART C — GOALS, GOOD FAITH EFFORTS, AND COUNTING
Section 26.43 Set-asides or Quotas
CITY OF PETALUMA does not use quotas in any way in the administration of this DBE
program.
Section 26.45 Overall Goals
CITY OF PETALUMA will establish an overall DBE goal covering a three-year federal
fiscal year period if it anticipates awarding DOT-funded prime contracts the cumulative
total value of which exceeds $250,000 in DOT funds during any one or more of the
reporting fiscal years within the three-year goal period. In accordance with §26.45(f),
CITY OF PETALUMA will submit its Overall Three-year DBE Goal to Federal Aviation
Administration by August 1 st of the year in which the goal is due, as required by the
schedule established by and posted to the website of Federal Aviation Administration.
FAA:
https : //www. faa . gov/about/office org/headquarters offices/a
cr/bus ent program/media/Schedule of DBE and ACDBE Reportin
g Requirements Dec 2017 Issue .pdf
I
The DBE goals will be established in accordance with the 2-step process as specified in
49 CFR Part 26.45. If CITY OF PETALUMA does not anticipate awarding prime
contracts the cumulative total value of which exceeds $250,000 in DOT funds during
any of the years within the three-year reporting period, an overall goal will not be
developed. However, this DBE Program will remain in effect and CITY OF PETALUMA
will seek to fulfill the objectives outlined in 49 CFR Part 26.1.
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Step 1. The first step is to determine a base figure for the relative availability of DBEs in
the market area. CITY OF PETALUMA will use [a Bidders List, a Disparity Study, the
goal of another DOT recipient, DBE Directory information and Census Bureau Data, or
other alternative method that complies with §26.45] as a method to determine the base
figure. CITY OF PETALUMA understands that the exclusive use of a list of prequalified
contractors or plan holders, or a bidders list that does not comply with the requirements
of 49 CFR Part 26.45(c)(2), is not an acceptable alternative means of determining the
availability of DBEs.
Step 2. The second step is to adjust, if necessary, the "base figure" percentage from
Step 1 so that it reflects as accurately as possible the DBE participation the recipient
would expect in the absence of discrimination. Adjustments may be made based on
past participation, information from a disparity study (to the extent it is not already
accounted for in the base goal), and/or information about barriers to entry to past
competitiveness of DBEs on contracts. CITY OF PETALUMA will examine all of the
evidence available in its jurisdiction to determine what adjustment, if any, is needed. If
the evidence does not suggest an adjustment is necessary, then no adjustment shall be
made.
Any methodology selected will be based on demonstrable evidence of local market
conditions and be designed to ultimately attain a goal that is rationally related to the
relative availability of DBEs in the CITY OF PETALUMA market.
In establishing the overall goal, CITY OF PETALUMA will provide for consultation and
publication. This includes consultation with minority, women's and general contractor
groups, community organizations, and other officials or organizations which could be
expected to have information concerning the availability of disadvantaged and non-
disadvantaged businesses, the effects of discrimination on opportunities for DBEs, and
the efforts by CITY OF PETALUMA to establish a level playing field for the participation
of DBEs. The consultation will include a scheduled, direct, interactive exchange (e.g., a
face-to-face meeting, video conference, teleconference) with as many interested
stakeholders as possible focused on obtaining information relevant to the goal setting
process, and it will occur before CITY OF PETALUMA is required to submit the goal
methodology to the operating administration for review pursuant to §26.45(f). The goal
submission will document the consultation process in which CITY OF PETALUMA
engaged. Notwithstanding paragraph (f)(4) of §26.45, the proposed goal will not be
implemented until this requirement is met.
In addition to the consultation described above, CITY OF PETALUMA will publish a
notice announcing the proposed overall goal before submission to the Federal Aviation
Administration on August 1st. The notice will be posted on CITY OF PETALUMA official
internet web site and may be posted in other sources (e.g., minority-focused media,
trade association publications). If the proposed goal changes following review by
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Federal Aviation Administration, the revised goal will be posted on the official internet
web site.
The public will also be informed that the proposed overall goal and its rationale are
available for inspection during normal business hours at the principal office of CITY OF
PETALUMA. This notice will provide that the CITY OF PETALUMA and Federal Aviation
Administration will accept comments on the goals for 30 days from the date of the
notice. Notice of the comment period will include the addresses to which comments may
be sent (including offices and websites) where the proposal may be reviewed. The
public comment period will not extend the August 1st deadline.
The Overall Three-Year DBE Goal submission to Federal Aviation Administration will
include a summary of information and comments received, if any, during this public
participation process and CITY OF PETALUMA responses.
CITY OF PETALUMA will begin using the overall goal on October 1 of the relevant
period, unless other instructions from Federal Aviation Administration have been
received.
Project Goals
If permitted or required by the Federal Aviation Administration Administrator, an overall
goal may be expressed as a percentage of funds for a particular grant or project or
group of grants and/or projects, including entire projects. Like other overall goals, a
project goal may be adjusted to reflect changed circumstances, with the concurrence of
the appropriate operating administration. A project goal is an overall goal, and must
meet all the substantive and procedural requirements of this section pertaining to overall
goals. A project goal covers the entire length of the project to which it applies. The
project goal will include a projection of the DBE participation anticipated to be obtained
during each fiscal year covered by the project goal. The funds for the project to which
the project goal pertains are separated from the base from which the regular overall
goal, applicable to contracts not part of the project covered by a project goal, is
calculated.
If a goal is established on a project basis, the goal will be used by the time of the first
solicitation for a DOT-assisted contract for the project.
Prior Operating Administration Concurrence
CITY OF PETALUMA understands that prior Federal Aviation Administration
concurrence with the overall goal is not required. However, if the Federal Aviation
Administration review suggests that the overall goal has not been correctly calculated or
that the method employed by CITY OF PETALUMA for calculating goals is inadequate,
Federal Aviation Administration may, after consulting with CITY OF PETALUMA , adjust
the overall goal or require that the goal be adjusted by CITY OF PETALUMA . The
adjusted overall goal is binding. In evaluating the adequacy or soundness of the
methodology used to derive the overall goal, the U.S. DOT operating administration will
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be guided by the goal setting principles and best practices identified by the Department
in guidance issued pursuant to §26.9.
A description of the methodology to calculate the overall goal and the goal calculations
can be found in Attachment 5 to this program.
Section 26.47 Failure to meet overall goals
CITY OF PETALUMA cannot be penalized or treated by the Department as being in
noncompliance with Part 26, because DBE participation falls short of an overall goal,
unless CITY OF PETALUMA fails to administer its DBE program in good faith.
CITY OF PETALUMA understands that to be considered to be in compliance with this
part, an approved DBE Program and overall DBE goal, if applicable, must be
maintained, and this DBE Program must be administered in good faith.
CITY OF PETALUMA understands that if the awards and commitments shown on the
Uniform Report of Awards or Commitments and Payments at the end of any fiscal year
are less than the overall goal applicable to that fiscal year, the following actions must be
taken in order to be regarded by the Department as implementing this DBE Program in
good faith:
(1) Analyze in detail the reasons for the difference between the overall goal and
the awards and commitments in that fiscal year;
(2) Establish specific steps and milestones to correct the problems identified in the
analysis to enable the goal for the new fiscal year to be fully met;
Section 26.51 Means Recipients Use to Meet Overall Goals
Breakout of Estimated Race-Neutral & Race-Conscious Participation
CITY OF PETALUMA will meet the maximum feasible portion of its overall goal by using
race-neutral means of facilitating race-neutral DBE participation. Race-neutral DBE
participation includes any time a DBE wins a prime contract through customary
competitive procurement procedures or is awarded a subcontract on a prime contract
that does not carry a DBE contract goal.
Race-neutral means include, but are not limited to the following:
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(1) Arranging solicitations, times for the presentation of bids, quantities,
specifications, and delivery schedules in ways that facilitate participation by
DBEs and other small businesses and by making contracts more accessible to
small businesses, by means such as those provided under §26.39.
(2) Providing assistance in overcoming limitations such as inability to obtain
bonding or financing (e.g., by such means as simplifying the bonding process,
reducing bonding requirements, eliminating the impact of surety costs from bids,
and providing services to help DBEs, and other small businesses, obtain bonding
and financing);
(3) Providing technical assistance and other services;
(4) Carrying out information and communications programs on contracting
procedures and specific contract opportunities (e.g., ensuring the inclusion of
DBEs, and other small businesses, on recipient mailing lists for bidders; ensuring
the dissemination to bidders on prime contracts of lists of potential
subcontractors; provision of information in languages other than English, where
appropriate);
(5) Implementing a supportive services program to develop and improve
immediate and long-term business management, record keeping, and financial
and accounting capability for DBEs and other small businesses;(6) Providing
services to help DBEs, and other small businesses, improve long-term
development, increase opportunities to participate in a variety of kinds of work,
handle increasingly significant projects, and achieve eventual self-sufficiency;
(7) Establishing a program to assist new, start-up firms, particularly in fields in
which DBE participation has historically been low;
(8) Ensuring distribution of the DBE directory, through print and electronic
means, to the widest feasible universe of potential prime contractors; and
(9) Assisting DBEs, and other small businesses, to develop their capability to
utilize emerging technology and conduct business through electronic media.
The breakout of estimated race-neutral and race-conscious participation can be found in
Attachment 5 to this program.
The CITY OF PETALUMA will arrange solicitations, times for the presentation of bids,
quantities, specifications, and delivery schedules in ways that facilitate participation by
DBEs and other small businesses and by making contracts more accessible to small
businesses, by means such as those provided under §26.39.
Contract Goals
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If the approved projection under paragraph (c) of §26.51 estimates that the entire
overall goal for a given year can be met through race-neutral means, contract goals will
not be set during that year, unless the use of contract goals becomes necessary in
order meet the overall goal.
Contract goals will be established only on those DOT-assisted contracts that have
subcontracting possibilities. A contract goal need not be established on every such
contract, and the size of contract goals will be adapted to the circumstances of each
such contract (e.g., type and location of work, availability of DBEs to perform the
particular type of work).
Contract goals will be expressed as a percentage of Federal share of a DOT-assisted
contract.
Section 26.53 Good Faith Efforts Procedures in Situations where there are
Contract Goals
Demonstration of good faith efforts (pre-award)
In cases where a contract goal has been established, the contract in question will only
be awarded to a bidder/offeror that has made good faith efforts to meet the contract
goal. The bidder/offeror can demonstrate that it has made good faith efforts by either
meeting the contract goal or documenting that it has made adequate good faith efforts
to do so. Examples of good faith efforts are found in Appendix A to Part 26.
DBELO is responsible for determining whether a bidder/offeror who has not met the
contract goal has documented sufficient good faith efforts to be regarded as
Responsive.
CITY OF PETALUMA will ensure that all information is complete and accurate and
adequately documents the bidder/offeror's good faith efforts before committing to the
performance of the contract by the bidder/offeror.
In all solicitations for DOT-assisted contracts for which a contract goal has been
established, the following information will be required of every bidder/offeror:
(1) Award of the contract will be conditioned on meeting the requirements of this
section;
(2) All bidders or offerors will be required to submit the following information to
the recipient, at the time provided in paragraph (3) of this section:
(i) The names and addresses of DBE firms that will participate in the
contract;
(ii) A description of the work that each DBE will perform. To count toward
meeting a goal, each DBE firm must be certified in a NAICS code applicable
to the kind of work the firm would perform on the contract;
(iii) The dollar amount of the participation of each DBE firm participating;
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(iv) Written documentation of the bidder/offeror's commitment to use a DBE
subcontractor whose participation it submits to meet a contract goal; and
(v) Written confirmation from each listed DBE firm that it is participating in the
contract in the kind and amount of work provided in the prime contractor's
commitment.
(vi) If the contract goal is not met, evidence of good faith efforts (as
elaborated in Appendix A of Part 26). The documentation of good faith efforts
must include copies of each DBE and non-DBE subcontractor quote
submitted to the bidder when a non-DBE subcontractor was selected over a
DBE for work on the contract; and
(3) The bidder/offeror will be required to present the information stipulated in
paragraph (2) of this section:
(4) [Select either responsiveness OR responsibility option]
Under sealed bid procedures, as a matter of responsiveness, or with initial
proposals, under contract negotiation procedures;
Administrative reconsideration
Within 10 days of being informed by CITY OF PETALUMA that it is not responsive
because it has not documented adequate good faith efforts, a bidder/offeror may
request administrative reconsideration. Bidder/offerors should make this request in
writing to the following reconsideration official:
Peggy Flynn
City Manager
City of Petaluma
11 English Street
Petaluma, CA 94952
707.778.4345
PFlynn@cityofpetaluma.org
The reconsideration official will not have played any role in the original determination
that the bidder/offeror did not document sufficient good faith efforts. The reconsideration
official is not someone who reports to the DBELO who made the original determination.
The reconsideration official is well-acquainted with the requirements outlined in
Appendix A of 49 CFR Part 26.
As part of this reconsideration, the bidder/offeror will have the opportunity to provide
written documentation or argument concerning the issue of whether it met the goal or
made adequate good faith efforts to do so. The bidder/offeror will have the opportunity
to meet in person with the reconsideration official to discuss the issue of whether the
goal was met or the bidder/offeror made adequate good faith efforts to do. The
bidder/offeror will be sent a written decision on reconsideration, explaining the basis for
finding that the bidder did or did not meet the goal or make adequate good faith efforts
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to do so. The result of the reconsideration process is not administratively appealable to
the Department of Transportation.
Good Faith Efforts procedural requirements (post-solicitation)
The awarded contractor will be required to make available upon request a copy of all
DBE subcontracts. The contractor shall ensure that all subcontracts or agreements with
DBEs to supply labor or materials include all required contract provisions and mandate
that the subcontractor and all lower tier subcontractors perform in accordance with the
provisions of Part 26.
Prime contractors will be prohibited from terminating a DBE subcontractor listed in
response to a covered solicitation (or an approved substitute DBE firm) without the prior
written consent of CITY OF PETALUMA. This includes, but is not limited to, instances
in which a prime contractor seeks to perform work originally designated for a DBE
subcontractor with its own forces or those of an affiliate, a non-DBE firm, or another
DBE firm.
Such written consent will be provided only if CITY OF PETALUMA agrees, for reasons
stated in the concurrence document, that the prime contractor has good cause to
terminate the DBE firm. For purposes of this paragraph, good cause includes the
following circumstances:
(1) The listed DBE subcontractor fails or refuses to execute a written contract;
(2) The listed DBE subcontractor fails or refuses to perform the work of its
subcontract in a way consistent with normal industry standards. Provided
however, that good cause does not exist if the failure or refusal of the DBE
subcontractor to perform its work on the subcontract results from the bad faith
or discriminatory action of the prime contractor;
(3) The listed DBE subcontractor fails or refuses to meet the prime contractor's
reasonable, non-discriminatory bond requirements.
(4) The listed DBE subcontractor becomes bankrupt, insolvent, or exhibits credit
unworthiness;
(5) The listed DBE subcontractor is ineligible to work on public works projects
because of suspension and debarment proceedings pursuant to 2 CFR Parts
180, 215 and 1,200 or applicable state law;
(6) CITY OF PETALUMA determined that the listed DBE subcontractor is not a
responsible contractor;
(7) The listed DBE subcontractor voluntarily withdraws from the project and
provides CITY OF PETALUMA written notice of its withdrawal;
(8) The listed DBE is ineligible to receive DBE credit for the type of work
required;
(9) A DBE owner dies or becomes disabled with the result that the listed DBE
contractor is unable to complete its work on the contract;
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(10) Other documented good cause that CITY OF PETALUMA has determined
compels the termination of the DBE subcontractor. Provided, that good cause
does not exist if the prime contractor seeks to terminate a DBE it relied upon
to obtain the contract so that the prime contractor can self-perform the work
for which the DBE contractor was engaged or so that the prime contractor can
substitute another DBE or non-DBE contractor after contract award.
Before transmitting to CITY OF PETALUMA a request to terminate and/or substitute a
DBE subcontractor, the prime contractor must give notice in writing to the DBE
subcontractor, with a copy to CITY OF PETALUMA, of its intent to request to terminate
and/or substitute the DBE, and the reason(s) for the request.
The prime contractor must give the DBE five days to respond to the prime contractor's
notice and advise CITY OF PETALUMA and the prime contractor of the reasons, if any,
why the DBE objects to the proposed termination of its subcontract and why the prime
contractor's action should not be approved. If required in a particular case as a matter
of public necessity (e.g., safety), a response period shorter than five days may be
provided.
In addition to post-award terminations, the provisions of this section apply to pre-award
deletions of or substitutions for DBE firms put forward by offerors in negotiated
procurements.
Each prime contract will include a provision stating:
The contractor shall utilize the specific DBEs listed in the contractor's
[bid/solicitation] response to perform the work and supply the materials for which
each is listed unless the contractor obtains prior written consent of CITY OF
PETALUMA as provided in 49 CFR Part 26, §26.53(f). Unless such consent is
provided, the contractor shall not be entitled to any payment for work or material
unless it is performed or supplied by the listed DBE.
CITY OF PETALUMA will require a contractor to make good faith efforts to replace a
DBE that is terminated or has otherwise failed to complete its work on a contract with
another certified DBE. These good faith efforts shall be directed at finding another DBE
to perform at least the same amount of work under the contract as the DBE that was
terminated, to the extent needed to meet the contract goal that was established for the
procurement. The good faith efforts shall be documented by the contractor. If CITY OF
PETALUMA requests documentation from the contractor under this provision, the
contractor shall submit the documentation within 7 days, which may be extended for an
additional 7 days, if necessary, at the request of the contractor. CITY OF PETALUMA
shall provide a written determination to the contractor stating whether or not good faith
efforts have been demonstrated.
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If the contractor fails or refuses to comply in the time specified, the contracting
office/representative of CITY OF PETALUMA may issue an order stopping all or part of
payment/work until satisfactory action has been taken. If the contractor still fails to
comply, the contracting officer may issue a termination for default proceeding.
Section 26.55 Counting DBE Participation
DBE participation will be counted toward overall and contract goals as provided in
§26.55. The participation of a DBE subcontractor will not be counted toward a
contractor's final compliance with its DBE obligations on a contract until the amount
being counted has actually been paid to the DBE.
In the case of post-award substitutions or additions, if a firm is not currently certified as
a DBE in accordance with the standards of subpart D of this part at the time of the
execution of the contract, the firm's participation will not be counted toward any DBE
goals, except as provided for in §26.870).
Pursuant to Sec. 150 of the FAA Reauthorization Act of 2018, firms that exceed the
business size standard in § 26.65(b) will remain eligible for DBE certification and credit
on FAA-funded projects as long as they do not exceed the small business size
standard, as adjusted by the United States Small Business Administration, for the
NAICS code(s) in which they are certified.
SUBPART D — CERTIFICATION STANDARDS
Section 26.61 — 26.73 Certification Process
CITY OF PETALUMA is a non-certifying member of the California Unified Certification
Program (UCP). California UCP will use the certification standards of Subpart D of Part
26 to determine the eligibility of firms to participate as DBEs in DOT-assisted contracts.
To be certified as a DBE, a firm must meet all certification eligibility standards. Certifying
California UCP members make all certification decisions based on the facts as a whole.
For information about the certification process or to apply for certification, firms should
contact:
Caltrans Office of Civil Rights
Attn: Certification Branch
PO Box 942874, MS 79
Sacramento, CA 94274
9161324-1700
Or
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https://dot.ca.gov/-/media/dot-media/programs/civil-
rights/documents/dbe/cucp-roster-of-certifying-agencies-1-2021-a11 y.pdf
The Uniform Certification Application form and documentation requirements are found in
Attachment 8 to this program.
SUBPART E — CERTIFICATION PROCEDURES
Section 26.81 Unified Certification Programs
CITY OF PETALUMA is a member of the Unified Certification Program (UCP)
administered by California Department of Transportation (Caltrans). This UCP meets all
of the requirements of this section.
SUBPART F — COMPLIANCE AND ENFORCEMENT
Section 26.101 Compliance Procedures Applicable to CITY OF PETALUMA
CITY OF PETALUMA understands that if it fails to comply with any requirement of this
part, CITY OF PETALUMA may be subject to formal enforcement action under
§26.103 or §26.105 or appropriate program sanctions by the concerned operating
administration, such as the suspension or termination of Federal funds, or refusal to
approve projects, grants or contracts until deficiencies are remedied. Program sanctions
may include, in the case of the FHWA program, actions provided for under 23 CFR
1.36; in the case of the FAA program, actions consistent with 49 U.S.C. 47106(d),
47111(d), and 47122; and in the case of the FTA program, any actions permitted under
49 U.S.C. chapter 53 or applicable FTA program requirements.
Section 26.109 Information, Confidentiality, Cooperation and intimidation or
retaliation
Information that may reasonably be regarded as confidential business information,
consistent with Federal, state, and local law will be safeguarded from disclosure to third
parties.
Notwithstanding any provision of Federal or state law, information that may reasonably
be construed as confidential business information will not be released to any third party
without the written consent of the firm that submitted the information, including
applications for DBE certification and supporting information. However, this information
will be transmitted to DOT in any certification appeal proceeding under §26.89 or to any
other state to which the individual's firm has applied for certification under §26.85.
All participants in the Department's DBE program (including, but not limited to,
recipients, DBE firms and applicants for DBE certification, complainants and appellants,
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and contractors using DBE firms to meet contract goals) are required to cooperate fully
and promptly with DOT and recipient compliance reviews, certification reviews,
investigations, and other requests for information. Failure to do so shall be a ground for
appropriate action against the party involved (e.g., with respect to recipients, a finding of
noncompliance; with respect to DBE firms, denial of certification or removal of eligibility
and/or suspension and debarment; with respect to a complainant or appellant, dismissal
of the complaint or appeal; with respect to a contractor which uses DBE firms to meet
goals, findings of non-responsibility for future contracts and/or suspension and
debarment).
CITY OF PETALUMA , contractor, or any other participant in the program will not
intimidate, threaten, coerce, or discriminate against any individual or firm for the
purpose of interfering with any right or privilege secured by this part or because the
individual or firm has made a complaint, testified, assisted, or participated in any
manner in an investigation, proceeding, or hearing under this part. CITY OF
PETALUMA understands that it is in noncompliance with Part 26 if it violates this
prohibition.
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ATTACHMENTS
[List and append]
Attachment 1 Regulations: 49 CFR Part 26
Attachment 2 Organizational Chart
Attachment 3 Bidder's List Collection Form
Attachment 4 DBE Directory or link to DBE Directory
Attachment 5 Overall Goal Calculations
Attachment 6 Demonstration of Good Faith Efforts or Good Faith Effort Plan - Forms 1
& 2
Attachment 7 DBE Monitoring and Enforcement Mechanisms
Attachment 8 DBE Certification Application Form
Attachment 9 State's UCP Agreement
Attachment 10 Small Business Element Program
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ATTACHMENT 1
Regulations: 49 CFR Part 26
The regulations can be viewed at the following website:
https://ecfr.io/Title-49/Part-26
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ATTACHMENT 2
CITY OF PETALUMA Organizational Chart
Organizational Chart
U City of Petaluma
Mayor and City Council
(CEO)
City Manager
(RO)
Engineering Manager
(DBELO)
Airport Operations
Updated 2/15/22
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ATTACHMENT 3
Bidder's List Collection Form
(SAMPLE BIDDERS LIST COLLECTION FORM)
[Reminder. the information below must be collected from every bidder who submits a
quote/bid to the recipient and every potential subcontractor who submitted a quote/bid to
each bidder. §26.11(c) requires recipients to collect information from all bidders and
subcontractors, including unsuccessful ones.]
DBE or Non-
Firm DBE Status
Firm Name Address/ (verify via Age of Firm Annual Gross Receipts
Phone# State's UCP
Directory)
❑ Less than 1 year ❑ Less than $500K
❑ 1- 3 years ❑ $500K-$1 million
❑ 4-7 years ❑ $1-2 million
❑ 8-10 years ❑ $2-5 million
❑ More than 10 years ❑ Greater than $5 million
❑ Less than 1 year ❑ Less than $500K
❑ 1- 3 years ❑ $500K-$1 million
❑ 4-7 years ❑ $1-2 million
❑ 8-10 years ❑ $2-5 million
❑ More than 10 years ❑ Greater than $5 million
❑ Less than 1 year ❑ Less than $500K
❑ 1- 3 years ❑ $500K-$1 million
❑ 4-7 years ❑ $1-2 million
❑ 8-10 years ❑ $2-5 million
❑ More than 10 years ❑ Greater than $5 million
❑ Less than 1 year ❑ Less than $500K
❑ 1- 3 years ❑ $500K-$1 million
❑ 4-7 years ❑ $1-2 million
❑ 8-10 years ❑ $2-5 million
❑ More than 10 years ❑ Greater than $5 million
❑ Less than 1 year ❑ Less than $500K
❑ 1- 3 years ❑ $500K-$1 million
❑ 4-7 years ❑ $1-2 million
❑ 8-10 years ❑ $2-5 million
❑ More than 10 years ❑ Greater than $5 million
❑ Less than 1 year ❑ Less than $500K
❑ 1- 3 years ❑ $500K-$1 million
❑ 4-7 years ❑ $1-2 million
❑ 8-10 years ❑ $2-5 million
❑ More than 10 years ❑ Greater than $5 million
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ATTACHMENT 4
California DBE Directory
The California Unified Certification Directory (CUCP) can be viewed at the following website:
htti)s://ucp.dot.ca.gov/IicenseForm.htm
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ATTACHMENT 5
Overall DBE Three-Year Goal Methodology
THIS SECTION UNDER DEVELOPMENT & SUBMITTED SEPARATELY
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ATTACHMENT 6
Demonstration of Good Faith Efforts - Forms 1 & 2
These forms will be provided as part of the solicitation documents for purposes of assessing
bidders'/offerors' good faith efforts
FORM 1: DISADVANTAGED BUSINESS ENTERPRISE (DBE) UTILIZATION
The undersigned bidder/offeror has satisfied the requirements of the bid specification in the
following manner:
❑ Bidder/offeror has met the DBE contract goal
The bidder/offeror is committed to a minimum of % DBE utilization on this contract.
❑ Bidder/offeror has not met the DBE contract goal
The bidder/offeror is committed to a minimum of % DBE utilization on this contract
and has submitted [or"will submit,"if recipient made compliance a matter of
responsibility] documentation demonstrating good faith efforts.
Legal name of bidder/offeror's firm:
Bidder/Offeror Representative:
Name & Title
Signature Date
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FORM 2: LETTER OF INTENT
Note: The authorized representative (AR) named below must be an individual vested with the
authority to make contracting decisions on behalf of the firm.
Name of bidder/offeror's firm:
Name & title of firm's AR:
Phone: Email:
Name of DBE firm:
Name & title of DBE firm's AR:
Address:
City: State: Zip:
Phone: Email:
Work to be performed by DBE firm:
Description of Work NAICS Dollar Amount/%* Dealer/Manufacturer"
*Percentage is to be used only in negotiated procurements, including design-build contracts
"For material suppliers only, indicate whether the DBE is a manufacturer or a regular dealer as defined by§26.55.
The undersigned bidder/offeror is committed to utilizing the above-named DBE firm for the work
described above. The total expected dollar value of this work is
$ . The bidder/offeror understands that if it is awarded the
contract/agreement resulting from this procurement, it must enter into a subcontract with the
DBE firm identified above that is representative of the type and amount of work listed.
Bidder/offeror understands that upon submitting this form with its bid/offer, it may not substitute
or terminate the DBE listed above without following the procedures of 49 CFR Part 26, §26.53.
Date:
Signature of Bidder/Offeror's Authorized Representative
The undersigned DBE affirms that it is ready, willing, and able to perform the amount and type
of work as described above, and is properly certified to be counted for DBE participation
therefore.
Date:
Signature of DBE's Authorized Representative
If the bidder/offeror does not receive award of the prime contract, any and all
representations in this Letter of Intent shall be null and void.
Submit this page for each DBE subcontractor.
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ATTACHMENT 7
DBE Monitoring and Enforcement Mechanisms
The CITY OF PETALUMA has available several remedies to enforce the DBE requirements
contained in its contracts, including, but not limited to, the following:
1. Breach of contract action, pursuant to the terms of the contract.
2. Breach of contract action, pursuant to California Civil Code, Article 1 Damages for
Breach of Contract 3300-3322
In addition, the Federal government has available several enforcement mechanisms that it may
apply to firms participating in the DBE problem, including, but not limited to, the following:
1. Suspension or debarment proceedings pursuant to 49 CFR Part 26
2. Enforcement action pursuant to 49 CFR Part 31
3. Prosecution pursuant to 18 USC 1001.
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ATTACHMENT 8
DBE Certification Application Form
Petaluma Municipal Airport(069) Page 33 of 36 49 CFR Part 26 Program
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OMB APPROVAL NO:
2105-0510
x Expiration Date: 10/31/2021
'�•.. Appendix F
UNIFORM CER TIFICA TION APPLICATION
DISADVANTAGED BUSINESS ENTERPRISE (DBE)/
AIRPORT CONCESSION DISADVANTAGED BUSINESS ENTERPRISE (ACDBE)
49 C.F.R. Parts 23 and 26
Roadmap for Applicants
1. Should I apply?
You may be eligible to participate in the DBE/ACDBE program if:
• The firm is a for-profit business that performs or seeks to perform transportation related work(or a concession
activity)for a recipient of Federal Transit Administration,Federal Highway Administration,or Federal Aviation
Administration funds.
• The firm is at least 5 1%owned by a socially and economically disadvantaged individual(s)who also controls it.
• The firm's disadvantaged owners are U.S.citizens or lawfully admitted permanent residents of the U.S.
• The firm meets the Small Business Administration's size standard and DBE/ACDBE size standards—
https://www.transportation.gov/DBEsizestandards
2.How do I apply?
First time applicants for DBE certification must complete and submit this certification application and related material
to the certifying agency in your home state and participate in an on-site interview conducted by that agency.The
attached document checklist can help you locate the items you need to submit to the agency with your completed
application.If you fail to submit the required documents,your application may be delayed and/or denied.Firms
already certified as a DBE do not have to complete this form,but may be asked by certifying agencies outside of your
home state to provide a copy of your initial application form,supporting documents,and any other information you
submitted to your home state to obtain certification or to any other state related to your certification.
3.Where can I send my application? [INSERT UCP PARTICIPATING MEMBER CONTACT INFORMATION]
4.Who will contact me about my application and what are the eligibility standards?A transportation agency in
your state that performs certification functions will contact you.The agency is a member of a statewide Unified
Certification Program(UCP),which is required by the U.S.Department of Transportation. The UCP is a one-stop
certification program that eliminates the need for your firm to obtain certification from multiple certifying agencies
within your state.The UCP is responsible for certifying firms and maintaining a database of certified DBEs and
ACDBEs,pursuant to the eligibility standards found in 49 C.F.R.Parts 23 and 26.
5.Where can I find more information?
U.S.DOT—https://www.transportation.gov/civil-rights(This site provides useful links to the rules and regulations
governing the DBE/ACDBE program,questions and answers,and other pertinent information)
SBA—Small Business Size Standards matched to the North American Industry Classification System(NAILS):
http://www.census.gov/eos/www/naics/and http://www.sba.gov/content/table-small-business-size-standards.
In collecting the information requested by this form,the Department of Transportation(Department)complies with the provisions of the Federal
Freedom of Information and Privacy Acts(5 U.S.C.552 and 552a).The Privacy Act provides comprehensive protections for your personal
information.This includes how information is collected,used,disclosed,stored,and discarded.Your information will not be disclosed to third
parties without your consent.The information collected will be used solely to determine your firm's eligibility to participate in the Department's
Disadvantaged Business Enterprise Program as defined in 49 C.F.R.§26.5 and the Airport Concession Disadvantaged Business Enterprise Program
as defined in 49 C.F.R.§23.3.You may review DOT's complete Privacy Act Statement in the Federal Register published on April 11,2000(65
FR 19477).
Under 49 C.F.R.§26.107,dated February 2,1999 and January 28,2011,if at any time,the Department or a recipient has reason to believe that any
person or firm has willfully and knowingly provided incorrect information or made false statements,the Department may initiate suspension or
debarment proceedings against the person or firm under 2 C.F.R.Parts 180 and 1200,No procurement Suspension and Department,take
enforcement action under 49 C.F.R.Part 31,Program Fraud and Civil Remedies,and/or refer the matter to the Department of Justice for criminal
prosecution under 18 U.S.C.1001,which prohibits false statements in Federal programs.
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INSTRUCTIONS FOR COMPLETING THE
DISADVANTAGED BUSINESS ENTERPRISE (DBE)
AIRPORT CONCESSIONS DISADVANTAGED BUSINESS ENTERPRISE (ACDBE)
UNIFORM CERTIFICATION APPLICATION
NOTE:All participating firms must be for-profit enterprises.If your firm is not for profit,then you do NOT qualify for
the DBE/ACDBE program and should not complete this application.If you require additional space for any question in
this application,please attach additional sheets or copies as needed,taking care to indicate on each attached sheet/copy
the section and number of this application to which it refers.
Section 1:CERTIFICATION INFORMATION (2) If you know the appropriate NAICS Code for the line(s)
of work you identified in your business profile, enter
A. Basic Contact Information the codes in the space provided.
(1) Enter the contact name and title of the person (3) State the date on which your firm was established as
completing this application and the person who will stated in your firm's Articles of Incorporation or
serve as your firm's contact for this application. charter.
(2) Enter the legal name of your firm,as indicated in your (4) State the date each person became a firm owner.
firm's Articles of Incorporation or charter. (5) Check the appropriate box describing the manner in
(3) Enter the primary phone number of your firm. which you and each other owner acquired ownership of
(4) Enter a secondary phone number,if any. your firm.If you checked"Other,"explain in the space
(5) Enter your firm's fax number,if any. provided.
(6) Enter the contact person's email address. (6) Check the appropriate box that indicates whether your
(7) Enter your firm's website addresses,if any. firm is"for profit."If you checked"No,"then you do
(8) Enter the street address of the firm where its offices are NOT qualify for the DBE/ACDBE program and
physically located(not a P.O.Box). should not complete this application. All participating
(9) Enter the mailing address of your firm,if it is different firms must be for-profit enterprises.Provide the Federal
from your firm's street address. Tax ID number as stated on your firm's Federal tax
return.
B. Prior/Other Certifications and Applications (7) Check the appropriate box that describes the type of
(10)Check the appropriate box indicating whether your firm legal business structure of your firm, as indicated in
is currently certified in the DBE/ACDBE programs, your firm's Articles of Incorporation or similar
and provide the name of the certifying agency that document. If you checked "Other," briefly explain in
certified your firm. List the dates of any site visits the space provided.
conducted by your home state and any other states or (8) Indicate in the spaces provided how many employees
UCP members. Also provide the names of state/UCP your firm has,specifying the number of employees who
members that conducted the review. work on a full-time, part-time, and seasonal basis.
(11)Indicate whether your firm or any firms owned by the Attach a list of employees,their job titles,and dates of
persons listed has ever been denied certification as a employment,to your application.
DBE/ACDBE, 8(a), or Small Disadvantaged Business (9) Specify the firm's gross receipts for each of the past
(SDB)firm,or state and local MBE/WBE firm.Indicate three years, as stated in your firm's filed Federal tax
if the firm has ever been decertified from one of these returns.You must submit complete copies of the firm's
programs.Indicate if the application was withdrawn or Federal tax returns for each year. If there are any
whether the firm was debarred,suspended,or otherwise affiliates or subsidiaries of the applicant firm or owners,
had its bidding privileges denied or restricted by any you must provide these firms'gross receipts and submit
state or local agency,or Federal entity.If your answer complete copies of these firm(s) Federal tax returns.
is yes, identify the name of the agency, and explain Affiliation is defined in 49 C.F.R. §26.5 and 13 C.F.R.
fully the nature of the action in the space provided. Part 121.
Indicate if you have ever appealed this decision to the
Department and if so,attach a copy of USDOT's final B.Relationships and Dealings with Other Businesses
agency decision(s). (1) Check the appropriate box that indicates whether your
firm is co-located at any of its business locations, or
Section 2:GENERAL INFORMATION whether your firm shares a telephone number(s),a post
office box, any office space, a yard, warehouse, other
A.Business profile: facilities,any equipment,financing,or any office staff
(1) Give a concise description of the firm's primary and/or employees with any other business,organization
activities, the product(s) or services the company or entity of any kind. If you answered "Yes," then
provides, or type of constriction. If your company specify the name of the other firm(s)and fully explain
offers more than one product/service, list primary the nature of your relationship with these other
product or service first (attach additional sheets if businesses by identifying the business or person with
necessary). This description may be used in our UCP whom you have any formal, informal, written,or oral
online directory if you are certified as a DBE.
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agreement.Provide an explanation of any items shared (3) (a) Check the appropriate box that indicates whether
with other firms in the space provided. this owner owns or works for any other firm(s)that has
(2) Check the appropriate box indicating whether any other aM relationship with your firm.If you checked"Yes,"
firm currently has or had an ownership interest in your identify the name of the other business,the nature of the
firm at present or at any time in the past.If you checked business relationship, and the owner's function at the
yes,please explain. firm.
(3) Check the appropriate box that indicates whether at (b) If the owner works for any other firm, non-profit
present or at any time in the past your firm: organization,or is engaged in any other activity more
(a) ever existed under different ownership,a different type than 10 hours per week,please identify this activity.
of ownership,or a different name; (4)(a)Provide the personal net worth of the owner applying
(b) existed as a subsidiary of any other firm; for certification in the space provided. Complete and
(c) existed as a partnership in which one or more of the attach the accompanying "Personal Net Worth
partners are/were other firms; Statement for DBE/ACDBE Program Eligibility"with
(d) owned any percentage of any other firm;and your application. Note, complete this section and
(e) had any subsidiaries of its own. accompanying statement only for each owner applying
(f) served as a subcontractor with another firm constituting for DBE qualification(i.e.,for each owner claiming to
more than 25%of your firm's receipts. be socially and economically disadvantaged).
(b) Check the appropriate box that indicates whether any
If you answered "Yes"to any of the questions in (3)(a-f), trust has been created for the benefit of the
you may be asked to explain the arrangement in detail. disadvantaged owner(s). If you answered "Yes," you
may be asked to provide a copy of the trust instrument.
Section 3:MAJORITY OWNER INFORMATION (5) Check the appropriate to indicate whether any of your
immediate family members,managers,or employees,
Identify all individuals or holding companies with any own,manage,or are associated with another company.
ownership interest in your firm, providing the information Immediate family member is defined in 49 C.F.R.
requested below (if your firm has more than one owner, §26.5.If you answered"Yes,"provide the name of
provide completed copies of this section for each owner): each person,your relationship to them,the name of
the company,the type of business,and whether they
A. Identify the majority owner of the firm holding 51% own or manage the company.
or more ownership interest
(1) Enter the full name of the owner. Section 4:CONTROL
(2) Enter his/her title or position within your firm.
(3) Give his/her home phone number. A. Identify the firm's Officers and Board of Directors
(4) Enter his/her home(street)address. (1) In the space provided, state the name, title, date of
(5) Indicate this owner's gender. appointment,ethnicity,and gender of each officer.
(6) Identify the owner's ethnic group membership. If you (2) In the space provided, state the name, title, date of
checked "Other," specify this owner's ethnic appointment, ethnicity, and gender of each individual
group/identity not otherwise listed. serving on your firm's Board of Directors.
(7)Check the appropriate box to indicate whether this owner (3) Check the appropriate box to indicate whether any of
is a U.S. citizen or a lawfully admitted permanent your firm's officers and/or directors listed above
resident. If this owner is neither a U.S. citizen nor a performs a management or supervisory function for any
lawfully admitted permanent resident of the U.S.,then other business. If you answered "Yes," identify each
this owner is NOT eligible for certification as a DBE person by name, his/her title, the name of the other
owner. business in which s/he is involved,and his/her function
(8) Enter the number of years during which this owner has performed in that other business.
been an owner of your firm. (4) Check the appropriate box that indicates whether any of
(9)Indicate the percentage of the total ownership this person your firm's officers and/or directors listed above own
holds and the date acquired,including(if appropriate), or work for any other firm(s)that has a relationship with
the class of stock owned. your firm.(e.g.,ownership interest,shared office space,
(10) Indicate the dollar value of this owner's initial financial investments, equipment leases, personnel
investment to acquire an ownership interest in your sharing,etc.)If you answered"Yes,"identify the name
firm, broken down by cash, real estate, equipment, of the firm, the individual's name, and the nature of
and/or other investment. Describe how you acquired his/her business relationship with that other firm.
your business and attach documentation substantiating
this investment.
B.Duties of Owners,Officers,Directors,Managers and
B.Additional Owner Information Key Personnel
(1) Describe the familial relationship of this owner to each
other owner of your firm and employees. (1),(2)Specify the roles of the majority and minority
(2) Indicate whether this owner performs a management or owners,directors,officers,and managers,and key
supervisory function for any other business. If you personnel who are responsible for the functions listed for
checked"Yes,"state the name of the other business and the firm.Submit resumes for each owner and non-owner
this owner's function/title held in that business. identified below.State the name of the individual,title,race
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and gender and percentage ownership if any.Circle the loan was made to your firm.Provide copies of signed loan
frequency of each person's involvement as follows: agreements and security agreements
"always,frequently,seldom,or never"in each area.
G.Contributions or transfers of assets to/from your firm
Indicate whether any of the persons listed in this section and to/from any of its owners or another individual over
perform a management or supervisory function for any other the past two years:
business. Identify the person, business, and their
title/function.Identify if any of the persons listed above own Indicate in the spaces provided,the type of contribution or
or work for any other firm(s)that has a relationship with this asset that was transferred,its current dollar value,the person
firm(e.g. ownership interest, shared office space, financial or firm from whom it was transferred,the person or firm to
investment, equipment, leases, personnel sharing, etc.) If whom it was transferred, the relationship between the two
you answered"Yes,"describe the nature of his/her business persons and/or firms,and the date of the transfer.
relationship with that other firm.
H. Current licenses/permits held by any owner or
C.Inventory:Indicate firm inventory in these categories: employee of your firm.
(1) Equipment and Vehicles List the name of each person in your firm who holds a
State the make and model, and current dollar value of professional license or permit,the type of permit or license,
each piece of equipment and motor vehicle held and/or the expiration date of the permit or license,and issuing State
used by your firm.Indicate whether each piece is either of the license or permit. Attach copies of licenses, license
owned or leased by your firm or owner, whether it is renewal forms,permits,and haul authority forms.
used as collateral,and where this item is stored.
I.Largest contracts completed by your firm in the past
(2) Office Space three years,if any.
State the street address of each office space held and/or
used by your firm.Indicate whether your firm or owner List the name of each owner or contractor for each contract,
owns or leases the office space and the current dollar the name and location of the projects under each contract,
value of that property or its lease. the type of work performed on each contract,and the dollar
value of each contract.
(3) Storage Space
State the street address of each storage space held J.Largest active jobs on which your firm is currently
and/or used by your firm.Indicate whether your firm or working.
owner owns or leases the storage space and the current For each active job listed, state the name of the prime
dollar value of that property or its lease. Provide a contractor and the project number,the location,the type of
signed lease agreement for each property. work performed, the project start date, the anticipated
completion date,and the dollar value of the contract.
D. Does your firm rely on any other firm for
management functions or employee payroll? Section 5:AIRPORT CONCESSION(ACDBE)
APPLICANTS
Check the appropriate box that indicates whether your firm
relies on any other firm for management functions or for Complete the entries in this section if you are applying for
employee payroll.If you answered"Yes,"you may be asked ACDBE certification.Indicate in Section A if you operate a
to explain the nature of that reliance and the extent to which concession at the airport,and/or supply a good or service to
the other firm carries out such functions. an airport concessionaire.Indicate in Section B whether the
applicant firm owns or operates any off-airport locations,
E.Financial/Banking Information providing the type of business, lease information,
address/location, and annual gross receipts generated.
State the name,City and State of your firm's bank.Identify Provide similar information in section C for any airport
the persons able to sign checks on this account.Provide bank concession locations the firm currently owns or operates.If
authorization and signature cards. the applicant firm has any affiliates,provide the requested
information in Section D.Indicate whether the ACDBE firm
Bonding Information.State your firm's bonding limits both is participating in any joint ventures, and if so, include the
aggregate and project limits. original and any amended joint venture agreements.
F. Sources, amounts, and purposes of money loaned to AFFIDAVIT&SIGNATURE
your firm, including the names of persons or firms
guaranteeing the loan. The Affidavit of Certification must accompany your
application. Carefully read the attached affidavit in its
State the name and address of each source, the name of entirety. Fill in the required information for each blank
person securing the loan, original dollar amount and the space, and sign and date the affidavit in the presence of a
current balance of each loan,and the purpose for which each Notary Public,who must then notarize the form.
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Section 1: CERTIFICATION INFORMATION
A.Basic Contact Information I am applying for certification as [-]DBE ❑ACDBE
(1) Contact person and Title: (2)Legal name of firm:
(3)Phone#: (�) - (4)Other Phone#: ( ) - (5)Fax#: ( ) -
(6)E-mail: (7)Firm Websites:
(8) Street address of firm (No P.O.Box): City: County/Parish: State: Zip:
(9)Mailing address Of firm(if different): City: County/Parish: State: Zip:
B.Prior/Other Certifications and Applications
(10)Is your firm currently certified for any of the following U.S.DOT programs?
❑ DBE ❑ ACDBE Names of certifying agencies:
O If you are certified in your home state as a DBE/ACDBE,you do not have to complete this application for other states.
Ask your state UCP about the interstate certification process.
List the dates of any site visits conducted by your home state and any other states or UCP members:
Date / / State/UCP Member: Date / / State/UCP Member:
(11)Indicate whether the firm or any persons listed in this application have ever been:
(a)Denied certification or decertified as a DBE,ACDBE, 8(a), SDB,MBE/WBE firm? ❑ Yes ❑No
(b)Withdrawn an application for these programs, or debarred or suspended or otherwise had bidding privileges
denied or restricted by any state or local agency, or Federal entity? ❑ Yes ❑ No
If yes, explain the nature of the action. (If you appealed the decision to DOT or another agency, attach a copy of the decision,
Section 2: GENERAL INFORMATION
A.Business Profile: (1)Give a concise description of the firm's primary activities and the product(s)or service(s)
it provides. If your company offers more than one product/service,list the primary product or service first. Please
use additional paper if necessary. This description may be used in our database and the UCP online directory if you
are certified as a DBE or ACDBE.
(2)Applicable NAICS Codes for this line of work include:
(3) This firm was established on / / (4)I/We have owned this firm since:
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tk(5) Method of acquisition (Check all that apply): }A�
❑ Started new business ❑ Bought existing business❑ Inherited business ❑ Gifted
❑ Merger or consolidation ❑ Other(explain) .,
(6) Is your firm "for profit"? ❑Yes No— ® STOP!If your firm is NOT for-profit,then you do NOT
Federal Tax ID# qualify for this program and should not fill out this application.
(7) Type of Legal Business Structure: (check all that apply):
❑ Sole Proprietorship
❑ Limited Liability Partnership
❑ Partnership El Corporation
❑ Limited Liability Company❑ Other,Describe
(8)Number of employees: Full-time Part-time Seasonal Total
(Provide a list of employees, their job titles, and dates of employment, to your application).
(9) Specify the firm's gross receipts for the last 3 years. (Submit complete copies of the firm's Federal tax returns for
each year.If there are affiliates or subsidiaries of the applicant firm or owners,you must submit complete copies of these
firms'Federal tax returns).
Year Gross Receipts of Applicant Firm$ Gross Receipts of Affiliate Firms $
Year Gross Receipts of Applicant Firm$ Gross Receipts of Affiliate Firms $
Year Gross Receipts of Applicant Firm$ Gross Receipts of Affiliate Firms $
B.Relationships and Dealings with Other Businesses
(1)Is your firm co-located at any of its business locations,or does it share a telephone number,P.O.Box,office
or storage space,yard,warehouse,facilities,equipment,inventory,financing,office staff,and/or employees with
any other business,organization,or entity? ❑ Yes ❑No
If Yes, explain the nature of your relationship with these other businesses by identifying the business or person with whom you
have any formal, informal, written, or oral agreement.Also detail the items shared
(2)Has any other firm had an ownership interest in your firm at present or at any time in the past?
❑ Yes ❑No If Yes, explain
(3)At present,or at any time in the past,has your firm:
(a)Ever existed under different ownership, a different type of ownership, or a different name? J Yes J No
(b)Existed as a subsidiary of any other firm? J Yes J No
(c)Existed as a partnership in which one or more of the partners are/were other firms? J Yes J No
(d)Owned any percentage of any other firm? ❑ Yes ❑ No
(e)Had any subsidiaries? ❑ Yes ❑No
(f) Served as a subcontractor with another firm constituting more than 25%of your firm's receipts? ❑ Yes ❑ No
(If you answered "Yes"to any of the questions in (2)and/or(3)(a)-69,you may be asked to provide further details and explain
whether the arrangement continues).
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Section 3: MAJORITY OWNER INFORMATION
A.Identify the majority owner of the firm holding 51% or more ownership interest.
(1)Full Name: (2)Title: (3)Home Phone#:
(4)Home Address(Street and Number): City: State: Zip:
(8)Number of years as owner:
(5) Gender: ❑ Male ❑ Female (9)Percentage owned: %
Class of stock owned: Date acquired
(6)Ethnic group membership (Check all that apply):
❑ Black (10)Initial investment to Tyne Dollar Value
❑ Hispanic acquire ownership Cash $
❑ Asian Pacific interest in firm: Real Estate $
❑Native American Equipment $
❑ Subcontinent Asian
Other $
❑ Other(specify) Describe how you acquired your business:
❑ Started business myself.
(7)U.S. Citizenship:❑ U.S. Citizen ❑ It was a gift from:
❑ Lawfully Admitted Permanent Resident ❑ I bought it from:
❑ I inherited it from:
❑ Other
(Attach documentation substantiating your investment)
B.Additional Owner Information
(1)Describe familial relationship to other owners and employees:
(2)Does this owner perform a management or supervisory function for any other business? ❑ Yes ❑ No
If Yes, identify: Name of Business: Function/Title:
(3)(a)Does this owner own or work for any other firm(s)that has a relationship with this firm? (e.g.,ownership
interest,shared office space,financial investments, equipment, leases,personnel sharing,etc.) ❑ Yes ❑ No
Identify the name of the business, and the nature of the relationship,and the owner's function at the firm:
(b)Does this owner work for any other firm,non-profit organization, or engage in any other activity more
than 10 hours per week? If yes,identify this activity:
(4)(a)What is the personal net worth of this disadvantaged owner applying for certification? $
(b)Has any trust been created for the benefit of this disadvantaged owner(s)? ❑ Yes ❑ No
(If Yes,you may be asked to provide a copy of the trust instrument).
(5)Do any of your immediate family members,managers,or employees own,manage, or are associated with
another company? ❑ Yes ❑No If Yes,provide their name,relationship, company,type of business, and
indicate whether they own or manage the company: (Please attach extra sheets, if needed):
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Section 3: OWNER INFORMATION, Cont'd. \
A.Identify all individuals,firms,or holding companies that hold LESS THAN 51% ownership interest in the \ �'
firm(Attach separate sheets for each additional owner) °1`
(1)Full Name: (2)Title: (3)Home Phone#:
(4)Home Address(Street and Number): City: State: Zip:
(5) Gender: ❑ Male ❑ Female (8)Number of years as owner:
(9)Percentage owned: %
(6)Ethnic group membership (Check all that apply) Class of stock owned: Date acquired
❑ Black (10) Initial investment
❑ Hispanic to acquire ownership Tyne Dollar Value
❑ Asian Pacific interest in firm: Cash $
❑Native American Real Estate $
❑ Equipment $Subcontinent Asian Other $
El Other(specify)
(7)U.S. Citizenship: Describe how you acquired your business:
❑ U.S. Citizen ❑ Started business myself.
❑ Lawfully Admitted Permanent Resident ❑ It was a gift from:
❑ I bought it from:
❑ I inherited it from:
❑ Other
(Attach documentation substantiating your investment)
B.Additional Owner Information
(1)Describe familial relationship to other owners and employees:
(2)Does this owner perform a management or supervisory function for any other business? ❑ Yes ❑No
If Yes,identify: Name of Business: Function/Title:
(3)(a)Does this owner own or work for any other firm(s)that has a relationship with this firm? (e.g.,ownership
interest,shared office space,financial investments, equipment, leases,personnel sharing,etc.) ❑ Yes ❑No
Identify the name of the business, and the nature of the relationship,and the owner's function at the firm:
(b)Does this owner work for any other firm,non-profit organization,or is engaged in any other activity
more than 10 hours per week?If yes, identify this activity:
(4)(a)What is the personal net worth of this disadvantaged owner applying for certification? $
(b)Has any trust been created for the benefit of this disadvantaged owner(s)? ❑ Yes ❑No
(If Yes,you may be asked to provide a copy of the trust instrument).
(5)Do any of your immediate family members, managers,or employees own,manage, or are associated
with another company? ❑ Yes ❑ No If Yes,provide their name, relationship, company, type of
business, and indicate whether they own or manage: (Please attach extra sheets, if needed):
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Section 4: CONTROL °"
A.Identify your firm's Officers and Board of Directors (If additional space is required, attach a separate sheet):
NAftl -
Name Title Date
Appointed Ethnicity Gender
(1)Officers of the Company (a)
(b)
(e)
d
(2)Board of Directors (a)
(b)
(c)
(d)
(3)Do any of the persons listed above perform a management or supervisory function for any other business?
❑ Yes ❑ No If Yes, identify for each:
Person: Title:
Business: Function:
Person: Title:
Business: Function:
(4)Do any of the persons listed in section A above own or work for any other firm(s)that has a relationship
with this firm? (e.g., ownership interest,shared office space,financial investments, equipment, leases,personnel sharing,etc.)
❑ Yes ❑No
If Yes, identify for each:
Firm Name: Person:
Nature of Business Relationship:
B.Duties of Owners,Officers,Directors,Managers, and Key Personnel
1. Complete for all Owners who are responsible for the following functions of the firm (Attach separate sheets as
needed).
Majority Owner(51%or more) Minority Owner(49%or less)
A=Always S=Seldom Name: Name:
F=Frequently N=Never Title: Title:
Percent Owned: Percent Owned:
Sets policy for company direction/scope A ❑ F ❑ S ❑ N ❑ A ❑ F ❑ S ❑ N ❑
of operations
Bidding and estimating A ❑ F ❑ S N ❑ A ❑ F ❑ S ❑ N ❑
Major purchasingdecisions A F S N A F S N
Marketingand sales A F S N A F S N
Supervises field operations A I F S I I N A F S N
Attend bid opening and lettings A F S N A ❑ F S N
Perform office management(billing, A ❑ F ❑ S N ❑ A ❑ F ❑ S ❑ N ❑
accounts receivable/payable,etc.
Hires and fires management staff A ❑ F ❑ S N A F S F N
Hire and fire field staff or crew A F S N A F F1 S r N
Designates profits spending or investment A L1 F S I N A F S N
Obligates business by contract/credit A F S I I I N I I A I F S 1 N
Purchase equipment A n I F S N 7 1 A F S N
Signs business checks I A F S LJ I N A I F S N
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2. Complete for all Officers,Directors,Managers,and Key Personnel who are responsible for the following
functions of the firm. (Attach separate sheets as needed). �I-..a
Officer/Director/Manager/Key Personnel Officer/Director/Manager/Key Personnel
A=Always S=Seldom Name: Name:
F=Frequently N=Never Title: Title:
Race and Gender: Race and Gender:
Percent Owned: Percent Owned:
Sets policy for company direction/scope A ❑ F ❑ S ❑ N ❑ A❑F ❑ S ❑ N ❑
of operations
Bidding and estimating A ❑ F ❑ S ❑ N ❑ A❑F 0 S N Lj
Major purchasin decisions A F S N 1 tAF
S N Lj
Marketingand sales A F HS N S N Lj
Supervises field operations A F S N S NAttend bid o enin and lettin s A F S N S NPerform office management(billing, A ❑ F ❑ S ❑ N ❑ ❑ S ❑ N
accounts receivable/payable,etc.
Hires and fires management staff A F S N A F S N LJ
Hire and fire field staff or crew A F S N A F S N
Designates profits spending or investment A 1 F S N A F SR:PN
N
Obligates business b contract/credit A F S ❑ N A F S Lj
Purchase equipment A Fj I F S I N AFJ F ❑ I S I N
Signs business checks A F S N A F Lj I S N Lj
Do any of the persons listed in B 1 or 132 perform a management or supervisory function for any other business?If Yes,
identify the person,the business,and their title/function:
Do any of the persons listed above own or work for any other firm(s)that has a relationship with this firm?(e.g.,
ownership interest,shared office space,financial investments, equipment, leases,personnel sharing,etc.)If Yes,describe the nature of
the business relationship:
C.Inventory: Indicate your firm's inventory in the following categories (Please attach additional sheets if needed):_
1.Equipment and Vehicles
Make and Model Current Owned or Leased Used as collateral? Where is item stored?
Value by Firm or Owner?
1.
2.
3.
4.
5.
6.
7.
8.
9.
2. Office Space
Street Address Owned or Leased by Firm or Owner? Current Value of Property or Lease
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v
3. Storage Space (Provide signed lease agreements for the properties listed)
Street Address Owned or Leased by Current Value of Property or Lease ..,, Y
Firm or Owner?
D.Does your firm rely on any other firm for management functions or employee payroll? ❑ Yes ❑ No
E.Financial/Banking Information (Provide bank authorization and signature cards)
Name of bank: City and State:
The following individuals are able to sign checks on this account:
Name of bank: City and State:
The following individuals are able to sign checks on this account:
Bonding Information: If you have bonding capacity, identify the firm's bonding aggregate and project limits:
Aggregate limit $ Project limit $
F.Identify all sources,amounts,and purposes of money loaned to your firm including from financial
institutions.Identify whether you the owner and any other person or firm loaned money to the applicant
DBE/ACDBE.Include the names of any persons or firms guaranteeing the loan,if other than the listed owner.
(Provide copies of signed loan agreements and security agreements).
Name of Source Address of Source Name of Person Original Current Purpose of Loan
Guaranteeing the Amount Balance
Loan
1.
2.
3.
G.List all contributions or transfers of assets to/from your firm and to/from any of its owners or another
individual over the past two years(Attach additional sheets if needed):
Contribution/Asset Dollar Value From Whom To Whom Relationship Date of
Transferred Transferred Transfer
1.
2.
3.
H.List current licenses/permits held by any owner and/or employee of your firm
(e.g. contractor, engineer, architect, etc)(Attach additional sheets if needed):
Name of License/Permit Holder Type of License/Permit Expiration Date State
1.
2.
3.
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I.List the three largest contracts completed by your firm in the past three years,if any:
Name of Name/Location of Type of Work Performed Dollar Value of
Owner/Contractor Project Contract
1.
2.
3.
J.List the three largest active jobs on which your firm is currently working:
Name of Prime Location of Type of Work Project Anticipated Dollar Value
Contractor and Project Project Start Date Completion of Contract
Number Date
1.
2.
3.
Additional Information:
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AV
SECTION 5-AIRPORT CONCESSION
(ACDBE APPLICANTS ONLY)
A. I am applying for ACDBE certification to: (check all that apply)
❑ Operate a concession at an airport ❑ Supply a good or service to an airport concessionaire
B. Does the applicant firm own/operate any off-airport locations?❑Yes❑No If Yes, identify the following
Type of Business Lease Lease Address/Location Annual Gross
(e.g.,F&B,News&Gift,Retail, Term Start Receipts Generated
Duty Free,Advertising,etc.) (years) Date
C. Does the applicant firm currently own/operate any airport concession locations? ❑Yes ❑No If Yes, supply
the following information:
Airport Name Concession Type Number of Number of Annual Gross Lease Type
(e.g.,F&B,News& Leases Locations Receipts (e.g.Direct Lease,Subcontract
Gift,Retail,Duty Free, Generated Management Agreement,etc. enter
Advertising,etc.) all that apply to the leases listed)
D. Does the applicant firm have any affiliates? El Yes❑No If Yes,provide the following information concerning
any locations owned/operated by affiliate firms.
Airport Name Concession Type Number of Number of Annual Gross Lease Type
(e.g.,F&B,News& Leases Locations Receipts (e.g.Direct Lease,Subcontract
Gift,Retail,Duty Free, Generated Management Agreement,etc. enter
Advertising,etc.) all that apply to the leases listed)
E.Is the ACDBE applicant firma participant in any joint ventures?El Yes❑No If Yes, attach all original and
any amended Joint Venture Agreements and any amendments to the agreements.
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AFFIDAVIT OF CERTIFICATION ;
This form must be signed and notarized for each owner upon which disadvantaged status is relied. fa- .v
A MATERIAL OR FALSE STATEMENT OR OMISSION MADE IN CONNECTION WITH THIS APPLICATION IS
SUFFICIENT CAUSE FOR DENIAL OF CERTIFICATION,REVOCATION OF A PRIOR APPROVAL,INITIATION
OF SUSPENSION OR DEBARMENT PROCEEDINGS,AND MAY SUBJECT THE PERSON AND/OR ENTITY
MAKING THE FALSE STATEMENT TO ANY AND ALL CIVIL AND CRIMINAL PENALTIES AVAILABLE
PURSUANT TO APPLICABLE FEDERAL AND STATE LAW.
I (full name printed),
swear or affirm under penalty of law that I am I acknowledge and agree that any misrepresentations in this
(title)of the applicant firm application or in records pertaining to a contract or subcontract
and that I will be grounds for terminating any contract or subcontract
have read and understood all of the questions in this which may be awarded;denial or revocation of certification;
application and that all of the foregoing information and suspension and debarment;and for initiating action under
statements submitted in this application and its attachments federal and/or state law concerning false statement,fraud or
and supporting documents are true and correct to the best of other applicable offenses.
my knowledge,and that all responses to the questions are full
and complete,omitting no material information.The responses I certify that I am a socially and economically disadvantaged
include all material information necessary to fully and individual who is an owner of the above-referenced firm seeking
accurately identify and explain the operations,capabilities and certification as a Disadvantaged Business Enterprise or Airport
pertinent history of the named firm as well as the ownership, Concession Disadvantaged Business Enterprise.In support of my
control,and affiliations thereof. application,I certify that I am a member of one or more of the
following groups,and that I have held myself out as a member of
I recognize that the information submitted in this application is the group(s): (Check all that apply):
for the purpose of inducing certification approval by a
government agency.I understand that a government agency ❑Female❑Black American❑ Hispanic American
may,by means it deems appropriate,determine the accuracy ❑Native American ❑Asian-Pacific American
and truth of the statements in the application,and I authorize ❑ Subcontinent Asian American ❑ Other(specify)
such agency to contact any entity named in the application,and
the named firm's bonding companies,banking institutions,
credit agencies,contractors,clients,and other certifying I certify that I am socially disadvantaged because I have been
agencies for the purpose of verifying the information supplied subjected to racial or ethnic prejudice or cultural bias,or have
and determining the named firm's eligibility. suffered the effects of discrimination,because of my identity
as a member of one or more of the groups identified above,
I agree to submit to government audit,examination and review without regard to my individual qualities.
of books,records,documents and files,in whatever form they
exist,of the named firm and its affiliates,inspection of its I further certify that my personal net worth does not exceed
places(s)of business and equipment,and to permit interviews $1.32 million,and that I am economically disadvantaged
of its principals,agents,and employees.I understand that because my ability to compete in the free enterprise system has
refusal to permit such inquiries shall be grounds for denial of been impaired due to diminished capital and credit
certification. opportunities as compared to others in the same or similar line
of business who are not socially and economically
If awarded a contract,subcontract,concession lease or disadvantaged.
sublease,I agree to promptly and directly provide the prime
contractor,if any,and the Department,recipient agency,or I declare under penalty of perjury that the information
federal funding agency on an ongoing basis,current,complete provided in this application and supporting documents is true
and accurate information regarding(1)work performed on the and correct.
project;(2)payments;and(3)proposed changes,if any,to the
foregoing arrangements. Signature
(DBE/ACDBE Applicant) (Date)
I agree to provide written notice to the recipient agency or
Unified Certification Program of any material change in the NOTARY CERTIFICATE
information contained in the original application within 30
calendar days of such change(e.g.,ownership changes,
address/telephone number,personal net worth exceeding$1.32
million,etc.).
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UNIFORM CERTIFICATION APPLICATION
SUPPORTING DOCUMENTS CHECKLIST
In order to complete your application for DBE or ACDBE certification,you must attach copies of all of the following
REQUIRED documents.A failure to supply any information requested by the UCP may result in your firm denied
DBE/ACDBE certification.
Required Documents for All Applicants ❑ Corporate by-laws and any amendments
❑ Corporate bank resolution and bank signature cards
❑ Resumes(that include places of employment with ❑ Official Certificate of Formation and Operating Agreement
corresponding dates),for all owners,officers,and key with any amendments(for LLCs)
personnel of the applicant firm
❑ Personal Net Worth Statement for each socially and Optional Documents to Be Provided on Request
economically disadvantaged owners who the applicant firm
relies upon to satisfy the Regulation's 51%ownership The certifying agency to which you are applying may require
requirement. the submission of the following documents.If requested to
❑ Personal Federal tax returns for the past 3 years,if provide these document,you must supply them with your
applicable,for each disadvantaged owner application or at the on-site visit.
❑ Federal tax returns(and requests for extensions)filed by
the firm and its affiliates with related schedules,for the past 3 ❑ Proof of citizenship
years. ❑ Insurance agreements for each truck owned or operated by
❑ Documented proof of contributions used to acquire your firm
ownership for each owner(e.g., both sides of cancelled ❑ Audited financial statements(if available)
checks) ❑ Trust agreements held by any owner claiming
❑ Signed loan and security agreements,and bonding forms disadvantaged status
❑ List of equipment and/or vehicles owned and leased ❑ Year-end balance sheets and income statements for the
including VIN numbers,copy of titles,proof of ownership, past 3 years(or life of firm, if less than three years)
insurance cards for each vehicle.
❑ Title(s),registration certificate(s),and U.S.DOT numbers Suppliers
for each truck owned or operated by your firm ❑ List of product lines carried and list of distribution
❑ Licenses,license renewal forms,permits,and haul equipment owned and/or leased
authority forms
❑ Descriptions of all real estate(including office/storage
space,etc.)owned/leased by your firm and documented proof
of ownership/signed leases
❑ Documented proof of any transfers of assets to/from your
firm and/or to/from any of its owners over the past 2 years
❑ DBE/ACDBE and SBA 8(a),SDB,MBE/WBE
certifications,denials,and/or decertification's,if applicable;
and any U.S.DOT appeal decisions on these actions.
❑ Bank authorization and signatory cards
❑ Schedule of salaries(or other remuneration)paid to all
officers,managers,owners,and/or directors of the firm
❑ List of all employees,job titles,and dates of employment.
❑ Proof of warehouse/storage facility ownership or lease
arrangements
Partnership or Joint Venture
❑ Original and any amended Partnership or Joint Venture
Agreements
Corporation or LLC
❑ Official Articles of Incorporation(signed by the state
official)
❑ Both sides of all corporate stock certificates and your
firm's stock transfer ledger
❑ Shareholders' Agreement(s)
❑ Minutes of all stockholders and board of director's meetings
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Revision Date: 2020-10-21
ATTACHMENT 9
State's UCP Agreement
Subpart E, of 49 CFR Part 26.81 requires DOT recipients to participate in a Unified Certification
Program (UCP) that shall provide one-stop shopping to applicants for DBE certification. The
California Unified Certification Program (CUCP) provides "one-stop shopping" certification
services to small, minority and women businesses seeking to participate in the United States
Department of Transportation (USDOT) Disadvantaged Business Enterprise (DBE) Program.
An agreement establishing the UCP for California was submitted to the Secretary of
Transportation and approved on March 13, 2002. The California UCP submitted their
Memorandum of Agreement (MOA) plan to the Secretary of Transportation on May 1, 2001. The
CUCP has subsequently revised its MOA over the years on January 1, 2002: March 24, 2003:
November 16, 2004: and March 21, 2006. The MOA stated that UCP members agreed to the
use of certifying agencies organized into two regional Clusters throughout the State of California
and comprised of the U.S. DOT modal administration's state highway agency, airports, and
transit agency grant recipients. Cluster 2 includes U.S.DOT recipients located in City of
Petaluma including the Petaluma Municipal Airport (069).
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ATTACHMENT 10
Small Business Element
The CITY OF PETALUMA will include this small business element into this DBE Program. This
small business element is intended to facilitate competition by and expand opportunities for
small businesses. We are committed to taking all reasonable steps to eliminate obstacles to
small businesses that may preclude their participation in procurements as contractors or
subcontractors. We will meet its objectives using a combination of the following methods and
strategies:
1. Objective/Strategies
(1) Some prime contracts anticipated to be under $150,000 will be set-aside for small
businesses. Those firms meeting the definition of a small business, as described below,
will be eligible for award of these contracts.
(2) In multi-year design-build contracts or other large contracts (e.g., for"megaprojects")
requiring bidders on the prime contract to specify elements of the contract or specific
subcontracts that are of a size that small businesses, including DBEs, can reasonably
perform.
(3) On prime contracts not having DBE contract goals, requiring the prime contractor to
provide subcontracting opportunities of a size that small businesses, including DBEs,
can reasonably perform, rather than self-performing all the work involved.
(4) Structuring procurements to facilitate small businesses, including DBEs, to compete for
and perform prime contracts.
(5) To meet the portion of your overall goal you project to meet through race-neutral
measures, ensuring that a reasonable number of prime contracts are of a size that small
businesses, including DBEs, can reasonably perform.
2. Definition
The definitions provided shall be in accordance with 49 CFR Part §26.39.
(1) Small Business:
Defined pursuant to section 3 of the Small Business Act and Small Business
Administration regulations implementing it (13 CFR part 121) that also does not exceed
the cap on average annual gross receipts specified in §26.65(b).
(2) Disadvantaged Business Enterprise:
At least 51 percent owned by one or more individuals who are both socially and
economically disadvantaged or, in the case of a corporation, in which 51 percent of the
stock is owned by one or more such individuals; and
The management and daily business operations are controlled by one or more of the
socially and economically disadvantaged individuals who own it.
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Revision Date: 2020-10-21
For the purposes of the small business element of the CITY OF PETALUMA DBE
Program, DBE's who are also defined as small businesses shall be in accordance with
49 CFR Part 26.
3. Verification
The CITY OF PETALUMA will accept the following certifications for participation in this small
business element of the DBE Program with applicable stipulations:
1. DBE Certification by the State of California — CUCP which stipulates that a firm has been
determined to meet all the requirements in accordance with 49 CFR Part 26.
Certification determinations are evidenced by inclusion in the listing of DBE's on the
CUCP DBE Directory.
2. State of California Small Business Development Programs as certified by the
Department of General Services:
Micro Businesses — MB
Small Businesses — SIB
Disabled Veteran Business Enterprise— DVBE
Non-Profit Veteran Service Agency- NSVA
Note: Minority and women-owned business enterprises which are awarded contracts under
the small business enterprise set aside will be encouraged to seek DBE certification in order
to be counted as DBE participation.
4. Monitoring/Record Keeping
1. Documentation regarding the small business element of this program will be organized
in a designated directory and will be monitored and updated on an annual basis with the
CITY OF PETALUMA administration.
2. This Small Business element will be monitored by reviewing project financial reporting
documentation.
5. Assurance
1. The program is authorized under state law;
2. Certified DBEs that meet the size criteria established under the program are
presumptively eligible to participate in the program;
3. No limits are placed on the number of contracts awarded to firms participating in the
program, but every effort will be made to avoid creating barriers to the use of new,
emerging, or untried businesses; and
4. Aggressive steps will be taken to encourage those minority and women owned firms that
are eligible for DBE certification to become certified.
5. The program is open to small businesses regardless of their location (i.e., there is no
local or other geographic preference).
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