Exhibit B _ Certificate of Minority Form.docx

This is a Certificate of Insurance and Minority Status form for the J-462 Renovation for the Criminal Justice Learning Lab and Public Safety project at Albany State University in Albany, Georgia. The form requires applying firms to provide their professional liability insurance carrier information, including the name and address of the insurance carrier, the amount of coverage, and the deductible per claim. The document serves as an official submission requirement for firms bidding on this renovation project and must be notarized before submission.

The form includes a section for firms to declare their minority status, with checkboxes for Minority Business Enterprise (MBE), Women Business Enterprise (WBE), or other designations. Both the applying firm and any associated firm must indicate their respective minority status classifications. The document must be signed by the applying firm's representative and notarized by a notary public, with the notary providing their commission expiration date. This certification requirement ensures compliance with insurance and minority business participation documentation for the contract opportunity.