FORM 2 - SBE AFFIDAVIT.pdf

FORM 2 - COMMERCIALLY USEFUL FUNCTION AFFIDAVIT

TO BE COMPLETED BY PRIME ONLY

PART A: AFFIDAVIT

An SBE performs a commercially useful function (CUF) when it is responsible for at least execution of the work of the contract and is carrying out its responsibilities by actually performing, managing, and supervising the work involve. An SBE does not perform a CUF if its role is limited to that of an extra participant in a transaction, contract, or project through which funds are passed in order to obtain the appearance of SBE participation.

The Bidder/Proposer acknowledges that it will perform at least 30% of the work for during the performance this contract with its own workforce in compliance with the CUF requirements.

The Bidder/Proposer declares to perform the following percentage of work with its own workforce:

_____________________________________________________________ Percent ( ____ %)

PART B: SIGNATURE

The undersigned Director, Officer, General Partner, or similarly situated Principal of the business declares he/she is informed and believe, and thereon allege, that to the best of their knowledge, information and belief, the information set forth on this page of this document and any attachments, is current, complete and accurate.

Executed on: _____________________, 20 ___, at, _____________________________, _________ (Date) (City) (State)

Business Name: ____________________________________________________________________

Business Address: __________________________________________________________________ (Street) (City) (State)

Authorized Signature: ________________________________________________________________

Printed Name: ___________________________________ Title: ______________________________

Phone: ______________________________ Email: _______________________________________