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PRIME BIDDER GOOD FAITH EFFORTWORKSHEET Page 2of2 <br />PART It --ADVERTISEMENTS <br />You must make at least two (2) advertisements, one (1) In a paper that focuses on DVBE and one (1) in a trade paper. Advertisements must be published at least i4 days prior to bid/ <br />proposal opening; if you cannot advertise 14 days prior, advertise as soon as possible and provide an explanation, (Advertisements must be published in time to allow fora reasonable <br />response.) Advertisements must include that your firm Is seeking DVBE participation, the project name and location, your firms name, your firm's contact person, and phone number. <br />Attach copies of advertisements to this form. <br />PART III—DVBE SOLICITATIONS <br />List DVBE subcontractors/suppilers that were invited to bid. Use the following Instructions to complete the remainder of this section (read the three columns as a sentence from <br />left to right), if you need additional space to list DVBE solicitations, please use a separate page and attach to this form. <br />iF THE DVBE... THEN... AND... <br />was 59 W9. -to parf{cipate Cheek "�(E$"7n ij�g "Si REt 7ED� cojui n)(nclptletEte ap iileabfA dolls► 8mo> ltt Sltide ti Cd. f thele DVBE jeer frim t)SDt <br />jet j'att IN of the P(iti� Bid"dgrCertieittiOtt vt <br />Df 1?Tsak�eci(etgran' farm , r <br />was not selected to participate check "NO" In the "SELECTED" column state why in the "REASON NOT SELECTED" column. <br />didnot respphd to'so)idt�tlon check fhb �[QO $SP+�NEi"column h ; x <br />r <br />DISABLED VETERANS BUSINESS ENTERPRISES CONTACTED SELECTED REASON NOT SELECTED NO <br />M I No I THIS SECTION MUST BE COMPLETED <br />Important Note <br />Please be aware that certification of the "Good Faith Effort" may only be made if you fully complete Parts 1, IL and III on both sides of this form. A copy of this form must be <br />retained by you and may be subject to a future audit. <br />CERTIFICATION <br />I, certify that I am the bidder's Chief Executive Officer and that I have made a diligent effort to <br />ascertain the facts with regard to the representations made herein. in making this certification, I am aware of Section 12650 et seq. of the Government Code <br />providing for the imposition of treble damages for making false claims. <br />SIGNATURE OF CHIEF EXECUTIVE OFFICER DATE <br />