Exhibit B _ Certificate of Minority Form.docx
DOCX document 33 KB Posted
- Attached to
- UGA, J-459-DP School of Nursing Building
- Solicitation number
- PE-47200-RFQ-2026-000000117
- Issued by
- Clayton County, Georgia
About this file
This is a Certificate of Minority Form exhibit associated with the University of Georgia's request for qualifications for design professional services for Project No. J-459-DP, the School of Nursing Building located in Athens, Georgia. The form functions as a certification document that respondents must complete to substantiate minority business enterprise (MBE) status or participation in the project delivery. The exhibit requires documentation of minority ownership and control, with specific sections for identifying minority-owned entities involved in the design services team.
The certificate form serves as a compliance and documentation tool for the procurement process, enabling the University of Georgia to track and verify minority participation commitments. Completion and submission of this form appears to be a required component of the RFQ response package, with the form providing standardized fields for certifying minority business status and detailing the scope of services or involvement by minority-controlled firms in the overall design professional services contract.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit A _ Certification Form.docx | DOCX document | |
| Exhibit C _ Project Team Composition Form.docx | DOCX document | |
| J_459 UGA School of Nursing DP RFQ.pdf | ||
| Exhibit G _ 179D Allocation Agreement.doc | DOC document | |
| Exhibit F _ Proposers Disclosure Statement.doc | DOC document | |
| Exhibit E _ Contractor Affidavit.docx | DOCX document | |
| Exhibit D _ DP Fee Proposal.doc | DOC document | |
| Egnyte Upload Instructions.pdf |
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Text version
Exhibit B J-459 School of Nursing Building University of Georgia, Athens, Georgia
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 .