Exhibit C - Small Business Self-Cert form.docx
DOCX document 25 KB Posted
- Attached to
- Rainier RHC Washers/Extractors
- Solicitation number
- PR2419305
- Issued by
- Pierce County, Washington
About this file
The document is a Small Business Self-Certification Statement for the state of Washington. It defines the criteria for Microbusiness, Minibusiness, and Small Business entities in the state of Washington, including requirements for gross revenue, number of employees, and location of the principal office.
The related state and local contract opportunity is for the purchase of washer/extractors for the Rainier Residential Habilitation Center in Pierce County, Washington. The scope includes demolition and removal of the existing equipment, and installation of the new Braun equipment. The contract is being offered by the state of Washington.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit E - Service Responsibilities.docx | DOCX document | |
| RFQ PR2419305 - Rainier Washers.doc | DOC document | |
| Exhibit D - Contractor Inclusion Plan.docx | DOCX document | |
| Exhibit A - DSHS Standard T&C's.pdf | ||
| Exhibit B - Bidder Certifications.docx | DOCX document | |
| Exhibit F - NDC Info Form.docx | DOCX document |
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Text version
SMALL, MINI, OR MICRO BUSINESS SELF-CERTIFICATION STATEMENT
Chapter 39.26.010 RCW, Definitions states:
(16) "Microbusiness" means any business entity, including a sole proprietorship, corporation, partnership, or other legal entity, that:
(a) Is owned and operated independently from all other businesses; and
(b) has a gross revenue of less than one million dollars annually as reported on its federal tax return or on its return filed with the department of revenue.
(17) "Minibusiness" means any business entity, including a sole proprietorship, corporation, partnership, or other legal entity, that:
(a) Is owned and operated independently from all other businesses; and
(b) has a gross revenue of less than three million dollars, but one million dollars or more annually as reported on its federal tax return or on its return filed with the department of revenue.
(22) "Small business" means an in-state business, including a sole proprietorship, corporation, partnership, or other legal entity, that:
(a) Certifies, under penalty of perjury, that it is owned and operated independently from all other businesses and has either:
(i) Fifty or fewer employees; or
(ii) A gross revenue of less than seven million dollars annually as reported on its federal income tax return or its return filed with the department of revenue over the previous three consecutive years; or
(b) Is certified with the office of women and minority business enterprises under chapter 39.19 RCW.
I hereby certify, under penalty of perjury, that [legal name of entity] meets the definition for the following type of business entity:
Verify that your principal office/place of business is located within Washington State.
(A principal office or principal place of business is the bidder’s headquarters where business decisions are made and the location for the bidder’s books and records as well as the bidder’s senior management personnel.)
Microbusiness Minibusiness Small Business
Signature of person authorized to sign on behalf of legal entity
Print name Date
File details come from the government source that posted it. Updated .