Preference for Businesses Owned by People with Disabilities Form
INSTRUCTIONS
In accordance with Section 34-236(b) of the Cook County Procurement Code, the Chief Procurement Officer (“CPO”) shall give a
preference of five percent of the amount of the Contract to a Responsible and Person with Disabilities Owned Business Enterprise
(“PDBE”) requesting a preference for Bids. All Bidders who are requesting this preference must complete the form and attach a
copy of its certification. Prior to applying the five percent preference, the CPO must receive approval from the Contract
Compliance Director (CCD) that the Bidder is a qualified PDBE.
DEFINITIONS
Persons with Disabilities Owned Business Enterprise (PDBE) means a small business (i) that is at least 51 percent owned. controlled
and managed by one or more Persons with a Disability; or in the case of a corporation, at least 51 percent or more of the stock of which
is owned, controlled, and managed by one or more Persons with a Disability; (ii) that has its home office in Illinois, as certified by the
CCD under policies and procedures promulgated by the CCD.
Disability or Disabled means, with respect to an individual, a physical or mental impairment that substantially limits one or more of the
major life activities of the individual, a record of physical or mental impairment that substantially limits one or more of the major life
activities of the individual, or being regarded as an individual with a physical or mental impairment that substantially limits one or more
of the major life activities of the individual.
Small Business means a small business as defined by the U.S. Small Business Administration, pursuant to the business size standards
found in 13 CFR Part 121, as related to the nature of the work the Person seeks to perform on Contracts. A Person is not an eligible
small business enterprise in any calendar fiscal year in which its gross receipts, averaged over the Person’s previous five fiscal years,
exceed the size standards of 13 CFR Part 121.
REQUEST FOR PREFERENCE
________ Bidder is requesting to receive a preference as a PDBE. By requesting this preference, Bidder certifies that it meets
the definition of a PDBE, as set forth above and has included a copy of its certification.
Bidder (please print or type) Title
Signature Date
E-mail address Phone Number
Subscribed to and sworn before me My commission expires:
this ____ day of , 20 .
X
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