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.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit F _ Proposers Disclosure Statement.doc | DOC document | |
| _J_465 CSU OAPR DP RFQ_RFP.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 | ||
| 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 .