Exhibit_B___Certificate_of_Minority_Form.docx

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Attached to
Project # 999-26-341 - Utilities, Stormwater and Landscape Campuswide Study
Solicitation number
PE-54300-RFQC-2026-000000114
Issued by
Cobb County, Georgia

About this file

Exhibit B is a certificate of insurance and minority status form required for the Kennesaw State University Project No. 999-26-341, Utilities, Stormwater and Landscape Campuswide Study, administered by the Board of Regents of the University System of Georgia. The form mandates that applying firms provide documentation of professional liability insurance coverage, including the carrier name and address, coverage amount, and deductible per claim. The certificate must be notarized and submitted as part of the qualifications response process. The deadline for submission of questions relating to the RFQ is specified in the Schedule of Events, with inquiries directed to Theresa Neylon, Senior Campus Planner, at tneylon@kennesaw.edu.

The form requires applicants to declare their minority status classification, with options to identify the applying firm and any associated firm as Minority Business Enterprise (MBE), Women Business Enterprise (WBE), or other designations. This certification serves as documentation of eligibility for potential set-asides or preferences in the competitive selection process. The Kennesaw State University project involves master planning services for utilities, stormwater, and landscape campuswide study across the Kennesaw and Marietta, Georgia campuses. Firms determined by the Owner to be especially qualified following initial submissions may be invited to participate in interviews for final selection.

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Text version

Exhibit B

CERTIFICATE OF INSURANCE AND MINORITY STATUS

INSURANCE:

Name of Applying Firm: _____________________________________________________

State the name and address of Applying Firm’s professional liability insurance carrier ____________________________________________________________________

Amount of coverage - $ ______________________________________________________

Amount of deductible per claim: $ ______________________________________________

MINORITY STATUS:

Indicate the status of the Applying Firm and Associated Firm, if applicable :

APPLYING FIRM: MBE_____ WBE_____ OTHER __________

ASSOCIATED FIRM: MBE_____ WBE_____ OTHER___________

______________________________________
Signature

Sworn and subscribed before me This ____day of ________, 20_____

NOTARY PUBLIC

NOTARY SEAL

My Commission expires: _________________

Gordon State College PPV-89-1201, Student Activity & Rec Ctr., PM RFQ/RFP

File details come from the government source that posted it. Updated .