Exhibit B _ Certificate of Minority Form.docx

DOCX document 33 KB Posted

Attached to
CSU_J-465-DP One Arsenal Place Renovation
Solicitation number
PE-47200-RFQ-2026-000000142
Issued by
Muscogee County, Columbus City, Georgia

About this file

This is a Certificate of Minority Form submitted in support of a Design Professional Services Request for Qualifications for Project No. J-465-DP, One Arsenal Place Renovation at Columbus State University in Columbus, Georgia. The form is utilized by interested design firms to certify their minority business enterprise status as part of the qualification and selection process for this architectural and engineering services project. The document serves as official documentation of a firm's minority ownership and control status, which may be relevant to the university's procurement preferences or reporting requirements.

The form establishes standardized criteria and declarations that design professional firms must complete and submit to demonstrate their eligibility under minority business enterprise classifications. This certification document is a prerequisite component of the RFQ submission package and supports Columbus State University's commitment to inclusive procurement practices. Firms must accurately complete and submit this form alongside their qualifications, project experience, team credentials, and other required documentation to be considered for award of the design professional services contract for the One Arsenal Place renovation project.

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Other files

File Type Posted
Exhibit F _ Proposers Disclosure Statement.doc DOC document
_J_465 CSU OAPR DP RFQ_RFP.pdf PDF
Exhibit D _ DP Fee Proposal.doc DOC document
Exhibit C _ Project Team Composition Form.docx DOCX document
Exhibit E _ Contractor Affidavit.docx DOCX document
Egnyte Upload Instructions_6.pdf PDF
Exhibit A _ Certification Form.docx DOCX document
Exhibit G _ 179D Allocation Agreement.doc DOC document

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Text version

Exhibit E Project No. J-465 One Arsenal Place Renovation Columbus State University, Columbus, 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 .