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DocuSign Envelope ID:4E43C797-33A3-4C29-9D23-96EA82AC437C <br /> Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid <br /> State of North Carolina AFFIDAVIT A- Listing of Good Faith Efforts <br /> County of <br /> (Name of Bidder) <br /> Affidavit of <br /> I have made a good faith effort to comply under the following areas checked: <br /> Bidders must earn at least 50 points from the good faith efforts listed for their bid to be <br /> considered responsive. (1 NC Administrative Code 30 1.0101) <br /> ❑ 1 —(10 pts)Contacted minority businesses that reasonably could have been expected to submit a quote and <br /> that were known to the contractor, or available on State or local government maintained lists, at least 10 days <br /> before the bid date and notified them of the nature and scope of the work to be performed. <br /> ❑ 2 --(10 pts) Made the construction plans, specifications and requirements available for review by prospective <br /> minority businesses,or providing these documents to them at least 10 days before the bids are due. <br /> ❑ 3—(15 pts) Broken down or combined elements of work into economically feasible units to facilitate minority <br /> participation. <br /> ❑ 4—(10 pts)Worked with minority trade, community, or contractor organizations identified by the Office of <br /> Historically Underutilized Businesses and included in the bid documents that provide assistance in <br /> recruitment of minority businesses. <br /> ❑ 5—(10 pts)Attended prebid meetings scheduled by the public owner. <br /> ❑ 6—(20 pts) Provided assistance in getting required bonding or insurance or provided alternatives to bonding <br /> or insurance for subcontractors. <br /> ❑ 7—(15 pts) Negotiated in good faith with interested minority businesses and did not reject them as <br /> unqualified without sound reasons based on their capabilities. Any rejection of a minority business based on <br /> lack of qualification should have the reasons documented in writing. <br /> ❑ 8—(25 pts) Provided assistance to an otherwise qualified minority business in need of equipment, loan <br /> capital, lines of credit, or joint pay agreements to secure loans, supplies, or letters of credit,including waiving <br /> credit that is ordinarily required. Assisted minority businesses in obtaining the same unit pricing with the <br /> bidder's suppliers in order to help minority businesses in establishing credit. <br /> ❑ 9—(20 pts) Negotiated joint venture and partnership arrangements with minority businesses in order to <br /> increase opportunities for minority business participation on a public construction or repair project when <br /> possible. <br /> ❑ 10-(20 pts) Provided quick pay agreements and policies to enable minority contractors and suppliers to <br /> meet cash-flow demands. <br /> The undersigned, if apparent low bidder, will enter into a formal agreement with the firms listed in the <br /> Identification of Minority Business Participation schedule conditional upon scope of contract to be <br /> executed with the Owner. Substitution of contractors must be in accordance with GS143-128.2(d) <br /> Failure to abide by this statutory provision will constitute a breach of the contract. <br /> The undersigned hereby certifies that he or she has read the terms of the minority business <br /> commitment and is authorized to bind the bidderto the commitment herein set forth. <br /> Date: Name of Authorized Officer: <br /> Signature: <br /> Title: <br /> State of ,County of <br /> SEAL Subscribed and sworn to before me this day of 20 <br /> Notary Public <br /> My commission expires <br /> MBForms 2002-Revised July 2010 <br />