Exhibit5-CBEForm.xlsx

This is a Certified Business Enterprise (CBE) Form exhibit related to a Request for Statement of Qualifications for Risk Consulting Services issued by the California County Chief Executive Office's Risk Management Branch. The form establishes certification and eligibility criteria for vendors seeking to qualify for a Master Agreement to provide one or more service categories including actuarial services, audit and compliance, data analytics, evaluation, feasibility studies, information systems, loss control and prevention, loss portfolio transfer, risk management training, subrogation recovery, and workers' compensation services. The RFSQ aims to support the County's objectives of placing employees in safe and effective working conditions, reducing illness and injury-related absences, minimizing disability-related retirements, and meeting legal mandates related to health, safety, and insurance while controlling costs.

The CBE Form functions as a certification document that vendors must complete to demonstrate their eligibility status as a certified business enterprise, which is a requirement for participation in this County contracting opportunity. The form verifies vendor compliance with certification standards and eligibility requirements necessary to enter into the Master Agreement with the County. All qualified vendors meeting the CBE certification criteria will be prequalified for potential selection to provide risk consulting services across the specified service categories on an as-needed basis under the County's Master Agreement structure.