Attach B1 Small Business Self Cert.docx
DOCX document 24 KB Posted
- Attached to
- Intercept Services
- Solicitation number
- 25-DCYF-CW-083
- Issued by
- Adams County, Asotin County, Benton County, Chelan County, Clallam County, Clark County, Columbia County, Cowlitz County, Douglas County, Ferry County, Franklin County, Garfield County, Grant County, Grays Harbor County, Island County, Jefferson County, King County, Kitsap County, Kittitas County, Klickitat County, Lewis County, Lincoln County, Mason County, Okanogan County, Pacific County, Pend Oreille County, Pierce County, San Juan County, Skagit County, Skamania County, Snohomish County, Spokane County, Stevens County, Thurston County, Wahkiakum County, Walla Walla County, Whatcom County, Whitman County, Yakima County, Asotin City, Clarkston City, Clarkston Heights-Vineland CDP, West Clarkston-Highland CDP, Benton City, Chelan City, Chelan Falls CDP, Clallam Bay CDP, Lewisville CDP, Rock Island City, Pacific Beach CDP, Whidbey Island Station CDP, Mercer Island City, Pacific City, Bainbridge Island City, Kingston CDP, Kitsap Lake CDP, Kittitas City, Klickitat CDP, Okanogan City, Anderson Island CDP, Fort Lewis CDP, Fox Island CDP, Herron Island CDP, Ketron Island CDP, North Fort Lewis CDP, Raft Island CDP, Tacoma City, Stevenson City, Hat Island CDP, Lake Stevens City, Snohomish City, Spokane City, Spokane Valley City, Puget Island CDP, Garfield Town, Yakima City, Washington
About this file
This is a Small Business Self-Certification Statement attachment for a Washington State Department of Children, Youth & Families (DCYF) contract opportunity for Intercept services. The document provides the definition and certification requirements for businesses seeking to qualify as a "small business" under the RFQ-25-DCYF-CW-083 Intercept solicitation, which aims to provide services to eligible children from birth to age 18 and their families involved in child welfare, children's mental health, and/or juvenile justice systems in Spokane and King Counties.
The document defines a small business as an in-state business that is independently owned and operated and meets one of two criteria: either having 50 or fewer employees, or having a gross revenue of less than $7 million annually as reported on federal income tax returns or Department of Revenue returns over the previous three consecutive years. The certification must be signed under penalty of perjury by an authorized representative of the business entity.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attach C1 Admin Response.docx | DOCX document | |
| AttachA Sample Contract RD 12-4.docx | DOCX document | |
| BidderResponseAttachC2 12-3.docx | DOCX document | |
| DCYF RFQ Solicitation Intercept 12-4.docx | DOCX document | |
| Attach B Certs & Assurances.docx | DOCX document | |
| Intercept Fee Table- Budget Info 11-21-24.xlsx | XLSX spreadsheet |
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Text version
ATTACHMENT B.1
BIDDER SMALL BUSINESS
SELF-CERTIFICATION STATEMENT
(21) "Small business" means an in-state business, including a sole proprietorship, corporation, partnership, or other legal entity, that:
(a) Certifies, under penalty of perjury, that it is owned and operated independently from all other businesses and has either:
(i) Fifty or fewer employees; or
(ii) A gross revenue of less than seven million dollars annually as reported on its federal income tax return or its return filed with the department of revenue over the previous three consecutive years;
I hereby certify, under penalty of perjury, that [legal name of entity] meets the above definition of “small business”.
Signature of person authorized to sign on behalf of legal entity
Written name
Date
RFQ-25-DCYF-CW-083 Intercept Page 3 of 3
File details come from the government source that posted it. Updated .