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Note: Bidders who continuously list the same Small M/WBE firms when contact has previously been unsuccessful as a result of disconnected numbers or returned mail will not be deemed in compliance with the Good Faith Effort requirements.

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ADDITIONAL INFORMATION:

Please provide additional information you feel will further explain your good and honest efforts to obtain Small M/WBE participation on this project.

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The Bidder further agrees to provide directly to TCCD upon request, complete and accurate information regarding actual work performed on this contract, the payment thereof, and any proposed changes to the original arrangements submitted with this bid. The Bidder also agrees to allow an audit and/or examination of any books, records, and files held by their company that will substantiate the actual work performed on this contract, by an authorized officer or employee of TCCD.

Any willful misrepresentation will be grounds for terminating the contract or debarment from TCCD work for a period of not less than three (3) years and for initiating action under federal, state, or local laws concerning false statements.

The undersigned certifies that the information provided and the Small M/WBE firm(s) listed was/were contacted in good faith. It is understood that any Small M/WBE firms listed will be contacted and the reasons for not using them can be verified.

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Authorized SignaturePrinted Signature

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TitleContact Name and Title (if different)

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Company NameTelephone Number(s)

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Address Fax Number

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City/State/Zip Date

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