SEED PROGRAM SMALL BUSINESS DECLARATION Complete this form to apply for SEED Program consideration. To qualify for the SEED Program, a firm must have a current certification as a Small Business from the California Department of General Services. In addition, the firm must qualify as a SMUD ratepayer for the preceding six months by receiving SMUD electric service at the principal office* listed by the Department of General Services. If your firm or one of your proposed subcontractors qualifies under these criteria, SMUD will validate all submitted information and determine the proposing firm’s SEED Program qualification. To expedite the verification process: 1) Submit a copy of the most recent SMUD statement for the principal office shown on your DGS Small Business application OR 2) If the firm leases its principal space from a property management company or a landlord and the SMUD utilities are included in the lease, please initial in the blank space provided above and attach a copy of the current lease showing the dates of occupancy, principal office of property and signatures of both parties AND Submit a copy of the current Small Business certification notice from the Department of General Services. Proposed SEED firm: Contact Name: Title: Phone Number: I hereby certify that this firm qualifies for the SEED Program as defined above. This firm has been certified as a Small Business by the California Department of General Services. I hereby swear that I am duly authorized to legally act on behalf of the above named company. Signed: Print Name: Title: Date: If you or one of your proposed subcontractors is not certified by DGS and would like to become certified for future contracting opportunities, please refer to or contact SMUD Supplier Diversity at (916) 732-5984 or email . *Principal office means where the business is headquartered and conducts the management and operations of the business.
DESIGNATION OF PRIME CONTRACTOR, SUBCONTRACTORS AND SUPPLIERS (TO BE COMPLETE BY ALL BIDDERS/PROPOSERS) The following are the names and business locations of the prime contractor and all subcontractors who will perform work or labor or render service to the Proposer in or about the work, or who will specially fabricate and install a portion of the work or improvement according to detailed drawings contained in the plans and specifications (as applicable) together with a statement of the portion of the work to be done by each subcontractor. SEED Program - The Proposer may only count toward its SEED Program subcontracting credit those expenditures to subcontractors or contractors under a subcontractor that perform a commercially useful function. In addition, each contractor or subcontractor claiming SEED Program qualification shall complete the SEED PROGRAM SMALL BUSINESS DECLARATION. Firm (Name and Address) Work, Material or Service (Provide Brief Description) Supplier Diversity/SEED Program Status Percent (%) (Of Total Proposal Price) Dollar Amount (Of This Firm's Work, Material or Service) 1. PROPOSER/PRIME CONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal 2. SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal 3. SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal 4. SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal
DESIGNATION OF PRIME CONTRACTOR, SUBCONTRACTORS, AND SUPPLIERS (Continuation Page ; may be duplicated as needed) SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal SUBCONTRACTOR Name Address City, State, Zip Primary Contact Phone # License Number & Classification SEED Qualified Yes No % of Total Proposal $ Amount of Total Proposal