Attachment No. 6 - Small Business Size Certification Form.pdf

This is a Small Business Size Certification form from the National Laboratory of the Rockies (OCFO-AS-4314, Revision 0, dated 11/19/2025).

The form is a template designed for contractors to certify their small business status in connection with subcontracts or purchase orders. Contractors must provide company information including name, address, contact details, and phone/email. The form requires selection of applicable small business classifications, including Small Business, Women-Owned Small Business, Veteran-Owned Small Business, Service-Disabled Veteran-Owned Small Business, Small Disadvantaged Business, and HUBZone Small Business certifications. For self-certifying small businesses, contractors must specify the NAICS code and corresponding size standard applicable to the work being contracted. The form includes a legal notice referencing 15 U.S.C. 645(d), which establishes penalties for misrepresentation of size status, including fines, imprisonment, administrative remedies, and ineligibility for Small Business Act programs. Contractors are directed to Federal Acquisition Regulation sections 2.101 and 52.219-8, as well as the SBA website, for assistance in determining accurate size classifications. The completed form requires authorized signature and date.