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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 /> <br />MBForms 2002-Revised May 2010 -1- <br />State of North Carolina AFFIDAVIT D – Good Faith Efforts <br /> <br />County of <br />(Note this form is to be submitted only by the apparent lowest responsible, responsive bidder.) <br /> <br />If the goal of 10% participation by HUB Certified/ minority business is not achieved, the Bidder shall <br />provide the following documentation to the Owner of his good faith efforts: <br /> Affidavit of I do hereby certify that on the (Name of Bidder) <br /> (Project Name) Project ID# Amount of Bid $ <br /> <br />I will expend a minimum of % of the total dollar amount of the contract with HUB certified/ <br />minority business enterprises. Minority businesses will be employed as construction subcontractors, <br />vendors, suppliers or providers of professional services. Such work will be subcontracted to the <br />following firms listed below. (Attach additional sheets if required) <br /> Name and Phone Number *Minority <br />Category <br />**HUB <br />Certified <br />Y/N <br />Work <br />Description <br />Dollar Value <br /> <br /> <br /> <br /> <br /> <br />*Minority categories: Black, African American (B), Hispanic (H), Asian American (A) American Indian (I), <br />Female (F) Socially and Economically Disadvantaged (D) <br />** HUB Certification with the state HUB Office required to be counted toward state participation goals. <br /> <br />Examples of documentation that may be required to demonstrate the Bidder's good faith efforts to meet the goals set forth in these provisions <br />include, but are not necessarily limited to, the following: <br />A. Copies of solicitations for quotes to at least three (3) minority business firms from the source list provided by the State for each subcontract <br />to be let under this contract (if 3 or more firms are shown on the source list). Each solicitation shall contain a specific description of the <br />work to be subcontracted, location where bid documents can be reviewed, representative of the Prime Bidder to contact, and location, <br />date and time 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, copies of quotes received from all <br />firms submitting quotes for that particular subcontract. <br />E. Documentation of any contacts or correspondence to minority business, community, or contractor organizations in an attempt to meet the <br />goal. <br /> F. Copy of pre-bid roster <br />G. Letter documenting efforts to provide assistance in obtaining required bonding or insurance for minority 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, lines of credit, or joint pay <br /> agreements to secure loans, supplies, or letter of credit, including waiving credit that is ordinarily required. <br />Failure to provide the documentation as listed in these provisions may result in rejection of the bid and award to the next lowest responsible <br />and responsive bidder. <br />Pursuant to GS143-128.2(d), the undersigned will enter into a formal agreement with Minority Firms for <br />work listed in this schedule conditional upon execution of a contract with the Owner. Failure to fulfill <br />this commitment may constitute a breach of the contract. <br />Docusign Envelope ID: 687B9CC7-F1BC-43DB-A291-A8D859EFA3B2