Exhibit6_CBEForm.xlsx

This is a Certified Business Enterprise (CBE) Form for the Los Angeles County Human Resources Department's Request for Sealed Quotation (RFSQ) for Dispute Resolution, Mediation and Related Services. The form serves as a certification document for vendors seeking to qualify as CBEs under Los Angeles County's contracting requirements. The document outlines the certification criteria and eligibility verification processes that prospective vendors must complete to participate in the DHR Mediation Program procurement. The form requests documentation of business ownership, operational control, and economic disadvantage status to establish CBE qualification for contract consideration.

The CBE Form establishes baseline requirements for vendor eligibility in the contracting process, with emphasis on demonstrating minority, women, and disadvantaged business enterprise status as defined by County policy. Vendors must provide detailed information regarding ownership structure, management participation, and financial documentation to support their certification claims. Completion and submission of this form is a mandatory prerequisite for bid consideration, and false certification statements may result in contract disqualification and legal consequences. The form functions as a gatekeeping mechanism to ensure that County contracting opportunities support established diversity and inclusion objectives while maintaining vendor accountability through rigorous documentation and verification standards.