Local_MBE_Form.pdf

MBE-1

MINORITY BUSINESS ENTERPRISE FORM

Respondent, please make copies of this form and fill out a separate form for each MBE Prime and Subcontractor.

Per Resolu�on 38-125, The City of Fort Myers has an MBE goal of 15%. Respondents are asked to document their good faith efforts in obtaining this goal.

☐ Prime Contractor ☐ Subcontractor (Check One) Required

Step 1: Prime Contractor Informa�on Name of the Firm:

Telephone: (A) Total Contract Amount:

Address:

City/ST/Zip:

Project/Solicita�on #:

Project Loca�on Address:

Authorized Representa�ve (Name/Title):

Email:

Step 2: MBE Contractor Informa�on Name of Firm:

Telephone: (B) MBE Dollar Amount (NA if Prime):

Address:

City/ST/Zip:

$ Amount of Labor/Service:

$ Amount of Materials:

Contract % (B/A):

Authorized Representa�ve (Name/Title):

Email:

Detailed descrip�on of the work to be performed:

Project Commitment Date:

Project Comple�on Date:

Step 3: Record of Transmital Leters. A transmittal letter should be sent to all MBE’s and contain information about the plans, specifications, blueprints, and requirements of the project to bid upon, including advising where such documents can be reviewed.

Good Faith Efforts should be directly tailored to the specific work items covered in this project that are intended to be subcontracted and soon to match the availability and assumed capability of applicable MBE’s. Please attach a copy of your transmittal letter, plus copies of all certified mail receipts or other method verifying delivery of the transmittal letter to the MBE’s.

In order to satisfy any contract goals that may be established in this project, for which bid proposals are requested, this pragmatic format has been developed to assist contractors, in a practical way, to document their “demonstrated” good faith efforts.

Firm Contacted Cer�fied Mail #/Method of Service

Date Mailed / Date Delivered

Step 4: Telephone/In-Person Visit Record: If this contact was made by telephone or “in-person” visits, please document specifically:

Date/Time Phone or In-Person Name/Title of Prime Contractor Name/Title of MBE Firm

Step 5: Incomplete/Non-Responsive Quota�ons: If bid quotations submitted by MBE’s are incomplete, non-responsive, irresponsible, or otherwise unacceptable, have you or any other official or agent of the prime followed-up by clearly explaining the deficiency (ies) or other reason

(s) why the bid is unacceptable? If so, please describe below the nature, substance, and scope of the deficiency (ies), and how, when, and with whom communicated.

Official Agent of the Prime (Name/Title)

Official Agent of the MBE (Name/Title)

Nature of the Deficiency of the Bid/Quote

Step 6: Non-U�lized MBE’s: If MBE bid is selected but not used, provide explanation of reason not used and the name and the amount of the sub-contractors utilized for this portion of work.

Reason for not u�lizing valid MBE for this project.