Exhibit_B___Certificate_of_Minority_Form.docx
DOCX document 33 KB Posted
- 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.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit G_KSU_campus maps.pdf | ||
| Exhibit H_KSU Transportation Study_2025_10.pdf | ||
| 999_26_187_Utility SW Landscape MP_PC RFQ_RFP.pdf | ||
| Exhibit_E___Contractor_Affidavit.docx | DOCX document | |
| Exhibit_F___Proposers_Disclosure_Statement.doc | DOC document | |
| Exhibit I_KSU_SWMP Update_Final.pdf | ||
| Exhibit_C___Project_Team_Composition_Form.docx | DOCX document | |
| Exhibit_D___DP_Fee_Proposal.doc | DOC document | |
| Exhibit_A___Certification_Form.docx | DOCX document |
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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 .