Exhibit B_ Certificate of Minority Form.docx
DOCX document 33 KB Posted
- Attached to
- SGSC, J-476-DP Library Renovation
- Solicitation number
- PE-47200-RFQ-2027-000000157
- Issued by
- Columbia County, Georgia
About this file
This is a Certificate of Minority Form exhibit for the South Georgia State College (SGSC) Library Renovation project (Project No. J-476-DP) in Douglas, Georgia. The document serves as a supporting exhibit for the Request for Qualifications (RFQ) related to design professional services for the library renovation project. The form is intended to be completed by design firms responding to the solicitation and appears to be part of the required documentation package that bidders must submit with their proposals. The specific requirements regarding completion deadlines, submission instructions, and detailed project scope are contained in the primary RFQ documents referenced in the solicitation.
The Certificate of Minority Form likely requires design firms to certify their minority business status or provide information regarding minority participation in their proposed project team. This form is typically used by Georgia public agencies to track and potentially give consideration to minority-owned or disadvantaged business enterprises in the procurement process. Firms submitting proposals should complete this certification form accurately and include it with all other required documentation as specified in the RFQ instructions for the SGSC Library Renovation project.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit C_ Project Team Composition Form.docx | DOCX document | |
| Exhibit G_ 179D Allocation Agreement.doc | DOC document | |
| Exhibit A_ Certification Form.docx | DOCX document | |
| Egnyte Upload Instructions.pdf | ||
| Exhibit F_ Proposers Disclosure Statement.doc | DOC document | |
| _SGSC J_476_DP RFQ_RFP.pdf | ||
| Exhibit D_ DP Fee Proposal.doc | DOC document | |
| Exhibit E_ Contractor Affidavit.docx | DOCX document |
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Text version
Exhibit E J-476 – Library Renovation South Georgia State College, Douglas, 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 .