Attachment B.1 Small Business.docx

This file is a Small Business Self-Certification Statement form for the Family Resource Center Case Closure Pilot contract opportunity in Washington State. The document serves as a self-certification tool for bidders to verify their status as small businesses under state definition. Bidders are required to certify, under penalty of perjury, that their legal entity meets the small business criteria and is owned and operated independently from all other businesses. The form requires authorization signatures and dates from appropriate representatives of the bidding entity.

Under Washington State's small business definition, qualifying businesses must meet one of two financial thresholds: they must have fifty or fewer employees, or demonstrate gross revenue of less than seven million dollars annually as reported on federal income tax returns or state department of revenue filings over the previous three consecutive years. The certification form is a prerequisite component of the bid submission process for this community-based prevention and support services contract, which aims to help families remain safe and stable while exiting Child Welfare involvement.