Exhibit B _ Certificate of Minority Form.docx

This is a Certificate of Insurance and Minority Status form for the J-466 Stickland Hall Renovation project at the University of North Georgia in Oakwood, Georgia, administered by Gordon State College. The document serves as an exhibit requirement for firms applying to bid on the renovation project. Applicants must provide their professional liability insurance carrier information, including the carrier's name and address, coverage amounts, and deductible per claim details. The form also requires certification of the applying firm's minority status classification, with checkboxes for Minority Business Enterprise (MBE), Women Business Enterprise (WBE), or other designations, as well as the same classifications for any associated firms.

The form requires notarization and must be executed by the applying firm with a sworn statement before a notary public. This certification document is a standard compliance requirement for state and local construction projects, particularly those involving university facilities. The form does not specify pricing information, contract terms, or submission deadlines within its content, as it functions solely as a certification and documentation vehicle for bidder qualifications and insurance requirements related to the project.