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Company State
DECLARATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED
In completing the narrative for consideration, the owner/owners of at least 51% of the business must
demonstrate that he or she is socially disadvantaged because t
hey have faced chronic, non-fleeting
instances of prejudice or bias without regard to their qualities as an individual, over which they have no
control, due to their identity as a member of a group as evidenced by the following:
1. Documentation proving that the individuals seeking social disadvantaged status as members of a group hold
themselves out as members of the group;
2. Documentation proving that the individuals seeking socially disadvantaged status have been isolated from
the mainstream of American society not common to business persons generally; and
3. Documentation proving that the individuals seeking socially disadvantaged status have personally suffered
social disadvantage through treatment they have experienced; and
Economically disadvantaged because of diminished opportunities that have precluded these
individuals from successfully competing in the open marketplace as evidenced by documentation on the
following:
1. The personal financial condition of the individual(s) seeking economically disadvantaged status;
2. The financial condition of the business enterprise; and
3. The applicant’s lack of access to credit and capital as compared to others in the same line of business.
INDIVIDUAL ELIGIBILITY CERTIFICATION
I declare, certify, verify, attest or state under penalty of perjury that thi
s form and the supporting documents
are true and correct to the best of my knowledge and belief. Pursuant to D.C. Official Code § 22-2402, any
person convicted of perjury shall be fined not more than $ 5,000 or imprisoned for not more than 10 years, or
both.
I certify that I am socially and economically disadvantaged in accordance with the requirements found under
Title 27 DCMR Section 803. I certify that the information provided in my narrative describing my personal
experience is true, accurate and complete to the best of my knowledge and belief.
By selecting the "I Accept" buttons above and typing your name in the Signature Box below, you are signing
this document electronically. You agree your electronic signature is the legal equivalent of your manual
signature on this document. By selecting "I Accept" you consent to be legally bound by the statute and
regulations governing the Certified Business Enterprise (CBE) program.
Company Zip
