MBE-ESB-3 Monthly Compliance Report Form Revised Date 9/1/2015
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 r egistered
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.
Minority Business Development
900 East Broad Street
City Hall, 16th Floor
Richmond, VA 23219
Office: (804) 646-5947
Fax: (804) 646-0136
Email: mbd.compliance@richmondgov.com
http://www.richmondgov.com/MBD
PLEASE ATTACH INVOICES FROM YOUR SUBCONTRACTORS
Contractor/Subcontractor
Sheet
of
Month/
Year
Date Submitted
to the
City of
Richmond
Project Name
Contract No.
Vendor Name
Address
Phone No./Fed ID No. or SSN
ESB
Subcontract
Complete
Scope of Work
Paid This Month
Paid-to-Date
Paid This Month
Paid-to-Date
Paid This Month
Paid-to-Date
Date Paid
Subcontract amt.
Date Paid
Subcontract
amt.
Date Paid
Subcontract amt.
Yes
No
ABC Co., Inc.
110 Main Street, Anywhere, USA
(XXX) 555-5555
54-XXXXXX
$2,000
$8,000
3/01/2008
$30,000
MONTHLY COMPLIANCE REPORT (MBE-3)
Minority Business Enterprise/Emerging Small Business
Monthly Compliance Monitoring Report
Instructions/Definitions
1. Vendor Name, Address, Phone No., Federal ID No. - provide vendor
name, address, phone number and include Federal ID number in
column.
2. MBE Paid This Month/Date Paid- provide amount paid to MBE
subcontractor/supplier during current pay application. (Definition of
Minority Business Enterprise (MBE)- a business that is at least 51%
owned and controlled by minority group members. In case of a publicly
owned business, at least 51% of the stock is minority owned and
minority group members control the business. Minority group members
are citizens of the United States who are African American, Hispanic
American, Asian American, or American Indian.
MBE Paid to Date provide total amount paid to MBE
subcontractor/supplier up to this pay application
Dollar Value of Subcontract provide total subcontract dollar amount
of original contract agreement. 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.
3. ESB Paid This Month provide amount paid to ESB
subcontractor/supplier during current pay application. (Definition of
Emerging Small Business (ESB) a business that (1) has been certified
by the Office of Minority Business Enterprise for a period of seven
years or less, (2) 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.
has annual gross receipts for each of its three fiscal years preceding
application for certification of $500,000 or less if engaged in the
construction of business or of $250,000 or less if engaged in a 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.
ESB Paid to Date provide total amount paid to ESB
subcontractor/supplier up to this pay application.
Dollar Value of Subcontract provide total subcontract dollar amount
of original contact agreement.
4. NON-MBE/ESB Paid This Month / Date Paid provide amount
paid to subcontractor/supplier during current pay application.
5. Subcontract Completed did the subcontract work or supplier satisfy
the conditions of the contract agreement?
6. Scope of Work describe work or service performed.
7. Invoices include all invoices for all payments.
8. MBE-3 Report & Invoices all MBE-3 forms and invoices can be
mailed or emailed to MBD.Compliance@RichmondGov.com
MBE-ESB-3 Monthly Compliance Report Form Revised Date 9/1/2015
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