14-MWBE HUB.pdf

This is a Minority/Women Business Enterprise (MWBE) and Historically Underutilized Businesses (HUB) certification form used by state and local government agencies for contract procurement processes. The form requires vendors to indicate their MWBE and/or HUB status, with some participating agencies requiring these certifications as part of their procurement requirements. Vendors must also provide a copy of their MWBE and/or HUB certification letter along with the percentage of their business conducted with MWBE and/or HUB suppliers in their proposal response attachments.

The form includes a certification section where an authorized company representative must attest to the accuracy of the residency certification and MWBE/HUB information provided. The form requires completion of standard business information including contractor name, address, phone and fax numbers, email address, and the printed name, title, and signature of the authorized representative with date. This appears to be a standard diversity certification requirement that supports government initiatives to increase participation of minority-owned, women-owned, and historically underutilized businesses in public contracting opportunities.