S3B-3_Section_3_Business_Self_Cert_.pdf
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- Solicitation number
- 2025-IFB-017
- Issued by
- Mohave County, Arizona
About this file
The document is a Section 3 Business Self-Certification Form (S3B-3) associated with the Jerry Ambrose Veterans Council Transitional Housing Rehab - Phase II project for the City of Kingman, Arizona. The form is designed for businesses seeking to qualify as a Section 3 Business under HUD regulations, with three primary certification options: businesses owned 51% or more by very-low or low-income persons, businesses owned 51% or more by public housing residents, or businesses where over 75% of labor hours are performed by very-low income employees or YouthBuild participants.
The self-certification form requires businesses to provide detailed company information and attest to their eligibility under Section 3 guidelines. By completing the form, the business certifies that it has documentation to verify its claims and agrees to make such documentation available to the recipient, the State of Arizona, the US Department of Housing and Urban Development, or their representatives. The form includes legal provisions warning that willful falsification of information can result in civil or criminal penalties, emphasizing the importance of accurate reporting and compliance with HUD's Section 3 business preferences.
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Text version
Section 3 Business Self-Certification Form (S3B-3)
A Section 3 Business shall certify and provide evidence the business is a Section 3 Business as defined in Section 24 CRF 75.
Business Name
Address
City, State, Zip Code
Federal ID Number
Contact Person
The business named above is 51% or more owned and controlled by very-low or low-income persons.
The business named above is 51% or more owned and controlled by public housing residents or residents currently residing in Section-8 assisted housing.
Over 75% of the labor hours worked during the past three months by employees of the business named above were performed by employees who are very-low or low-income, or YouthBuild participants.
I hereby certify that:
1. The undersigned has the legal authority to make these certifications on behalf of the named business.
2. Documentation exists to verify the basis for this self-certification.
3. Documentation will be made available to the recipient, the State of Arizona, the US Department of Housing and Urban Development, or their designated representatives during normal business hours upon request.
4. I am aware that both I and the business named above are liable for civil or criminal penalties for willful falsification of any information provided in this document.
Name of Person Completing Form
Title of Person Completing Form
Signature
Date
Section 3 Business Self-Certification Form (S3B-3)
File details come from the government source that posted it. Updated .