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Do not submit with the bid Do not submit with the bid Do not submit with the bid Do not submit with the bid Do not submit with the bid <br /> State of North Carolina AFFIDAVIT D — Good Faith Efforts <br /> ' County of <br /> (Note this form is to be submitted only by the apparent lowest responsible, responsive bidder.) <br /> ' If the goal of 10% participation by minority business is not achieved, the Bidder shall provide the <br /> following documentation to the Owner of his good faith efforts: <br /> ' (Name of Bidder) <br /> Affidavit of: <br /> I do certify the attached documentation as true and accurate representation of my good faith efforts. <br /> Attach additional sheets if re uired <br /> ' Name and Phone Number *Minority Work description Dollar Value <br /> Category <br /> ' *Minority categories: Black,African American (B), Hispanic(H),Asian American (A)American Indian (1), <br /> Female(F)Socially and Economically Disadvantaged (D) <br /> Documentation of the Bidder's good faith efforts to meet the goals set forth in these provisions. <br /> ' Examples of documentation include, but are not limited to, the following evidence: <br /> A. Copies of solicitations for quotes to at least three(3)minority business firms from the source list provided <br /> by the State for each subcontract to be let under this contract(if 3 or more firms are shown on the source <br /> ' list). Each solicitation shall contain a specific description of the work to be subcontracted, location where <br /> bid documents can be reviewed, representative of the Prime Bidder to contact, and location, date and time <br /> when quotes must be received. <br /> ' B. Copies of quotes or responses received from each firm responding to the solicitation. <br /> C.A telephone log of follow-up calls to each firm sent a solicitation. <br /> D. For subcontracts where a minority business firm is not considered the lowest responsible sub-bidder, <br /> ' copies of quotes received from all firms submitting quotes for that particular subcontract. <br /> E. Documentation of any contacts or correspondence to minority business, community, or contractor <br /> organizations in an attempt to meet the goal. <br /> F. Copy of pre-bid roster. <br /> G. Letter documenting efforts to provide assistance in obtaining required bonding or insurance for minority <br /> business. <br /> H. Letter detailing reasons for rejection of minority business due to lack of qualification. <br /> I. Letter documenting proposed assistance offered to minority business in need of equipment, loan capital, <br /> lines of credit,or joint pay agreements to secure loans, supplies, or letter of credit, including waiving credit <br /> that is ordinarily required. <br /> Failure to provide the documentation as listed in these provisions may result in rejection of the bid and <br /> award to the next lowest responsible and responsive bidder. <br /> ' Date: Name of Authorized Officer: <br /> Signature: <br /> ' Title: <br /> SEAL State of North Carolina, County of <br /> Subscribed and swom to before me this day of 20 <br /> Notary Public <br /> My commission expires <br /> MBFonns 2002-R <br /> t <br />