DISC 1245 Attachment 3 - Affirmation of Business Status LOCKED.docx

This is an Affirmation of Business Status form issued by the New York State Office of Children and Family Services (OCFS), Procurement Unit, Bureau of Contract Management, to be completed by principal officers or designated representatives of business enterprises seeking to provide services or sell commodities to OCFS. The form serves as a certification document for contract eligibility purposes under State Finance Law Section 163(6) discretionary buying thresholds. Bidders must complete and submit the form to affirm their organization's legal business classification and status in New York State.

The form requires vendors to identify their business structure by selecting from options including corporation, limited liability corporation, professional corporation, professional limited liability corporation, sole proprietorship, partnership, or limited liability partnership. Additionally, vendors must indicate if they qualify as a New York State Small Business Enterprise (employing 100 or fewer persons and meeting domicile and independence requirements), a New York State-certified Minority/Women-owned Business Enterprise (M/WBE) under Article 15-A of State Executive Law with ESD certification, or a New York State-certified Service-Disabled Veteran-Owned Business (SDVOB) under Article 3 of Veterans' Services Law with OGS certification. The affirmation must be signed by an authorized representative with name, title, company name, and date provided as evidence of accurate representation of the business's legal status for contract purposes.