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 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 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 .