MBE/ESB PARTICIPATION FORM (MBE-2)
Minority Business Development
900 East Broad Street
City Hall, 16th Floor, Suite 1603
Richmond, VA 23219
Office: (804) 646-5947
Fax: (804) 646-0136
http://www.RichmondGov.com/MBD
All firms listed in this directory have registered with the City of Richmond
as a minority owned business (MBE) or certified as an Emerging Small
Business (ESB). It should be noted, that there are MBE businesses listed in
this directory that are not certified. Therefore, any prime contractor/vendor
desiring to use a registered MBE firm that is not certified, must be aware,
that the registered MBE firm has 180 days to get certified or before the
completion of the contract, whichever is less, or the prime
contractor/vendor risks not receiving credit toward the minority
participation goal for the said project.
MBE/ESB-2 Participation Commitment Form Revised Date 4/9/2015
COMPANY DATA
COMPANY NAME:
PROJECT NAME/CONTRACT No.
CONTACT NAME:
PHONE #
Fax#
Email:
BUSINESS LICENSE No.
BUSINESS LICENSING
JURISDICTION:
FED ID NO/SSN
A= First, Second, and/or Third Tier Subcontracting B=Supply Purchases
C=Joint Venture D= Mentor-Protégé E = Other Credibly Viable Method
ENTER
CODES
BELOW
1 = African American 2 = Hispanic American 3 = Asian American
4 = American Indian 5 = Other (Specify Below)
Minority / Emerging Small Business Commitments
SUBCONTRACTOR NAME
PHONE
SCOPE OF WORK FOR
PARTICIPATION IN
CONTRACT
DOLLAR
AMOUNT
PARTICIPATION
ADDRESS
FED ID
NO./SSN
% OF
CONTRACT
OWNERSHIP
¹ ABC Co., Inc.
(XXX) 555-5555
Concrete Work
$20,000
A
110 Main Street
Anywhere, USA
54-XXXXXX
Other Excavation
10%
2
²
³
*IF OWNED TYPE 5 = OTHER
SPECIFY HERE:
TOTAL DOLLAR
AMOUNT
MBE/ESB PROJECT GOAL ESTABLISHED
BY THE CITY OF RICHMOND
TOTAL % OF
CONTRACT
Bidder and the MBE/ESB agree that the MBE/ESB shall not subcontract or assign any work described herein to another entity without prior written
approval of the City of Richmond.
THE UNDERSIGNED HEREBY CERTIFIES THAT S/HE HAS READ THE TERMS OF THIS COMMITMENT AND IS AUTHORIZED TO BIND
THE BIDDER TO THE COMMITMENT HEREIN SET FORTH.
SIGNATURE OF AUTHORIZED OFFICIAL: DATE:
INSTRUCTIONS / DEFINITIONS
1. SUBCONTRACTOR a business hired by the prime contractor to perform a specific aspect of the contract.
(Provide name of company, address and telephone number.)
2. SCOPE OF WORK A commercially useful function performed by the contractor.
3. EMERGING SMALL BUSINESS (ESB) A business that (1) has been certified by the Office of Minority
Business Development (OMBD) for a period of seven years or less, (2) has annual gross receipts for each of its
three fiscal years preceding application for certification of $500,000 or less if engaged in the const ruction
business or of $250,000 or less if engaged in non-construction business, (3) has fewer than ten employees, (4) is
not a subsidiary of another business and does not belong to a group of businesses owned and controlled by the
same individuals, (5) has its principal place of business within the City of Richmond Enterprise Zone, (6)
possesses a City business license, and (7) pays personal property, real estate, and business taxes to the City of
Richmond.
4. MINORITY BUSINESS ENTERPRISE (MBE) A business at least 51% of which is owned and controlled
or 51% operated by minority group members or, in case of a stock corporation, at least 51% of the stock, which
is owned and controlled by minority group members. Minority group members are citizens of the Unite d States
who are African American, Hispanic American, Asian American and American Indian.
5. FIRST, SECOND, AND/OR THIRD-TIER SUBCONTRACTING The scope of work that is initially
contracted by the prime contractor to a subcontractor is considered 1
st
-tier subcontracting. If that subcontractor
further subcontracts all or a portion of the work, it becomes 2
nd
-tier subcontracting. Likewise, if the 2
nd
-tier
subcontractor decides to subcontract a portion of the work, it is 3
rd
-tier subcontracting. The prime contractor
will receive credit for 100% of the dollar value of the 1
st
, 2
nd
, 3
rd
-tier subcontracting for MBE/ESB participation.
In summary, only work performed by MBE/ESBs counts toward the minority participation goal. Refer to City of
Richmond Office of Minority Business Development Policy and Procedures Section 6-1.0 through 6-5.10.
6. SUPPLY PURCHASES The prime contractor will receive credit for 100% of the dollar value of supplies
purchased from an MBE/ESB.
7. MENTOR/PROTÉGÉ An arrangement based on a written development plan, approved by the City, which
clearly sets forth the objectives of the parties and their respective roles, the duration of the arrangement and the
services and resources to be provided by the mentor to the protégé. MBE/ESB credit for a legitimate
mentor/protégé arrangement will be four (4) points toward the satisfaction of the MBE/ESB goal for the
specified project.
8. JOINT VENTURE An arranged partnership of the MBE/ESB and one or more other firms to carry out a
single, for-profit project, for which the parties combine their property, capital, efforts, skills and knowledge, and
in which the MBE/ESB is responsible for a distinct, clearly defined scope of work and whose share of the capital
contributions, control, management, risks, and profits of the joint venture are commensurate with its ownership
interest. MBE/ESB credit for legitimate joint ventures will be five (5) points toward the satisfaction of
the MBE/ESB goal for a specified project.
9. OTHER CREDIBLY VIABLE METHODS BLANKET BONDING The prime contractor covers the
bonding requirement for the subcontractor. MBE/ESB credit for Blanket Bonding will be two (2) points
toward the satisfaction of the MBE/ESB goal for a specified project .
Apprenticeship An apprentice that is bound to work for another for a designated amount of time in return for
instruction in a trade or business. MBE/ESB credit for Apprenticeship will be one (1) point toward the
satisfaction of the MBE/ESB goal for a specified project.
10. DOLLAR AMOUNT & PERCENTAGE OF CONTRACT MBE/ESB monetary value and percentage of the
subcontract.
MBE/ESB-2 Participation Commitment Form Revised Date 4/9/2015
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