Minority Business Development
900 East Broad Street
City Hall, 16th Floor
Richmond, VA 23219
Office: (804) 646-5947
Fax: (804) 646-0136
http://www.richmondgov.com/MBD
Good-Faith Minority Business Enterprise
and Emerging Small Business Participation Efforts
Documentation of Contacts
All firms listed in this directory have registered with the City of Richmond as a minority owned
business (MBE) or certified as an Emerging Sma ll Business (ESB) . It should be noted, that there
are MBE businesses listed in this directory that are not certified. Therefore, any prime
contractor/v endor desiring to use a registered MBE firm tha t is not certified, must be aware, that
the registered MBE firm has 180 days to get certi fied or before th e completion of the contract,
whichever is less, or the prime contractor/vendor risks not receiv ing credit toward the minority
participation goal for the said project.
Request for Qualification or Request for Proposals No.:
Project Name:
Name of Contractor:
Part I Method of Contact
How did you contact each Minority Business Enterprise or Emerging Small Business?
A. Telephone. For each firm contacted: YES NO How many MBE/ESB firms were contacted?
State the name of the firm, the name of the person contacted, the telephone number contacted and the date of the contact.
B. Fax. For each firm contacted: YES NO How many MBE/ESB firms were faxed information regarding this project?
State the name of the firm, the fax number contacted and the date of the contact.
Attach a copy of the fax transmittal sheet indicating receipt of the fax.
C. E-Mail. For each firm contacted: YES NO How many MBE/ESB firms were emailed?
State the name of the firm, the name of the person contacted by e-mail, the e-mail address at which you contacted the person and the date of the contact.
Attach a copy of the e-mail sent. All copies of e-mails must include metadata indicating From, To and Cc e -mail addresses as well as the date and time of the e-
mail.
D. Newspapers and Other Publications. For each advertisement placed in a newspaper or other publication: YES NO
State the name of the newspaper or other publication and the date or dates on which the advertisement was published.
Attach a copy of both the published advertisement and any solicitation advertised.
E. Other. For methods of contact not included above: YES NO If yes, see below instructions
Describe the nature of the contact.
As applicable, state the name of the person contacted, the name of the firm contacted and the date of the contact.
Attach a copy of any written documentation of the contact.
Attachment A sets forth the form in which the information required above must be submitted.
MBE/ESB-4 Good Faith Effort Form - Revised Date 1/1/2014
(Turn Over)
Additional copies can be made
MBE/ESB-4 Good Faith Effort Form - Revised Date 1/1/2014
MBE/ESB Name
Contact Person
Address
Phone Number
Fed ID Number
Telephone
Fax
Email
Newspaper or
Other Publication
Other
Response of
Contacted Firms
Telephone #
&
Date of
Contact
Fax #
&
Date of
Contact
Email Address
&
Date of Contact
Name of Newspaper
or Other Publication
Date (s) of
Advertisement
Separate Written
Statement with
any supporting
documentation
for each contract
MBE/ESB Response
Yes, No, No
Response or
Comment
ABC Co., Inc.
Joe Johns
110 Main Street, Anywhere, USA
(XXX) 555-5555
54-XXXXXX
(804) 555-
5555
01/28/09
(804) 555-
5555
01/28/09
ABC@gmail.com
Times Dispatch
See
Attachment
Yes
Attachment A Form of Information Documenting
Method of Contact
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