Attach B1 Small Business Self Cert 12-18.docx

This document is a Small Business Self-Certification Statement attachment for a Washington State contract opportunity (RFQQ 26-DCYF-CW-097) related to Stakeholder Engagement services under the Department of Children, Youth, and Families. The attachment requires bidders to certify their small business status under penalty of perjury. A qualifying small business is defined as an in-state business, including sole proprietorships, corporations, partnerships, or other legal entities that are independently owned and operated and meet at least one of two criteria: either maintaining fifty or fewer employees, or generating less than seven million dollars in gross revenue annually as documented on federal income tax returns or state department of revenue filings over the previous three consecutive years.

Bidders must execute the certification statement by providing their legal entity name, authorized signatory signature, printed name, and date. This self-certification is a prerequisite requirement for small business contractors seeking to participate in the stakeholder engagement solicitation, which involves collecting and communicating stakeholder input regarding implementation progress and adherence to trauma-informed, LGBTQIA+ affirming, and culturally responsive practices related to the Kinship Engagement, Family Group Planning and Referrals, and Transitions systemic improvements under the D.S. Lawsuit and Settlement Agreement.