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Minority/Women Business Enterprise Disclosure Affidavit

  1. Form

  2. (% of Minority Ownership or % of Female Ownership)

  3. (This is how your business will be categorized and listed in our Certified Vendors List).

  4. (If necessary, list additional names on a separate sheet and attach to this form.)

    (Identify applicant firm's current bonding company and bank)

  5. (Do not list rental or leased equipment.)

  6. (The Affidavit is mandatory. Please attach, mail in, or fax)

  7. Leave This Blank:

  8. This field is not part of the form submission.