Fillable SECTION 3 PARTICIPATION CERTIFICATION FOR BUSINESS CONCERNS SEEKING (Columbus Metropolitan Housing Authority)

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SECTION 3 PARTICIPATION CERTIFICATION FOR BUSINESS CONCERNS SEEKING (Columbus Metropolitan Housing Authority)

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SECTION 3 PARTICIPATION
CERTIFICATION FOR BUSINESS CONCERNS SEEKING SECTION 3 BUSINESS PREFERENCE
IN CONTRACTING AND DEMONSTRATION OF CAPABILITY
NAME OF BUSINESS:
ADDRESS OF BUSINESS:
TYPE OF BUSINESS:
Corporation
Partnership
Joint Venture
Attached is the following documentation as evidence of status:
For business claiming status as a Section 3 resident-owned Enterprise:
Copy of resident lease
Other evidence
Copy of evidence of participation in a public assistance program
For the business entity as applicable:
Copy of Articles of Incorporation
Certificate of Good Standing
Assumed Business Name Certificate
Partnership Agreement
List of owners/stockholder and % of each
Corporation Annual Report
Latest Board minutes appointing officers
Additional documentation
Organization chart with names and titles and brief functional statement
For business claiming Section 3 status by subcontracting 25% of the dollar awarded to qualified Section 3
business:
List of subcontracted Section 3 business and subcontract amount
For business claiming Section 3 status, claiming at least 30% of their workforce are currently Section 3
residents or were Section 3 eligible residents within 3 years of date of first employment with the business:
List of all current full time employees
List of all employees claiming Section 3 status
PHA Residential lease (less than 3 years
Other evidence of Section 3 status (less than3 years
from date of employment)
from date of employment)
Evidence of ability to perform successfully under the terms and conditions of the proposed contract:
Current financial statement
List of owned equipment
Statement of ability to comply
List of all contracts for the past 2 years with public policy
Corporate Seal
Authorizing Name and Signature
Notary
My term expires:
Title
_____________________________________________________________________________________
Signature Date Printed Name
SUGGESTED AFFIRMATIVE ACTION PLAN FOR UTILIZATION OF PROJECT AREA BUSINESSES
Number Of All Contracts Proposed:
Name Of Company:
Dollar Value Of All Contracts Proposed:
Project:
To The Greatest Extent Feasible, Contracts Will Be Awarded Through Negotiation Or Proposal To Qualified
Project Area Businesses.
Goal Of These Contracts For Project Area Businesses:
PROPOSED TYPE OF CONTRACT
APPROX. COST
PROPOSED TYPE OF CONTRACT
APPROX. COST
Outline The Program To Achieve These Goals For Economically And Socially Disadvantaged:
NOTE: To Complete The Affirmative Action Plan, Follow Steps Outlines In Attached Exhibit.
(INSERT THIS DOCUMENT IN PROPOSAL DOCUMENTS AND
WITH PROPOSAL)
DATE:
_____________________________________________________________________________________
Signature Date Printed Name
SUGGESTED AFFIRMATIVE ACTION PLAN FOR UTILIZATION OF PROJECT AREA BUSINESSES
(con'd)
SUGGESTED SECTION 3 PRELIMINARY WORKFORCE STATEMENT UTILIZATION OF LOWER INCOME PROJECT AREA
RESIDENTS AS REGULAR, PERMANENT EMPLOYEES, TRAINEES, APPRENTICES.
COMPANY NAME:
ADDRESS:
PROJECT:
PRESENT PERMANENT
EMPLOYEES
(At Time of Contract Signing)
SECTION 3
WORKFORCE
PROJECTION
(Residents)
TOTAL
PROJECTED
WORKFORCE
INCREASE
TRAINEES
APPRENTICES
JOURNEYPERSONS
LABORERS
SUPERVISORY
SUPERINTENDENT
PROFESSIONAL
CLERICAL
NOTE: RESIDENTS ARE THOSE LOWER INCOME PROJECT AREA RESIDENTS WHO HAVE BEEN QUALIFIED AS
ELIGIBLE.
_____________________________________________________________________________________
Signature Date Printed Name
PREFERENCE FOR SECTION 3 BUSINESS CONCERNS IN CONTRACTING
OPPORTUNITIES
The HA has established the following priority for preference when providing contracting opportunities to
Section 3 Businesses:
Priority I
Category 1a Business
Business concerns that are 51 percent or more owned by residents of the housing development
or developments for which the Section 3-covered assistance is expended.
Priority II
Category 1b Business
Business concerns whose workforce includes 30 percent of residents of the housing development
for which the Section 3-covered assistance is expended, or within three (3) years of the date of
first employment with the business concern, were residents of the Section 3-covered housing
development.
Priority III
Category 2a Business
Business concerns that are 51 percent or more owned by residents of any other housing
development or developments.
Priority IV
Category 2b Business
Business concerns whose workforce includes 30 percent of residents of any other public housing
development or developments, or within three (3) years of the date of first employment with the
business concern, were “Section 3” residents of any other public housing development.
Priority V
Category 3 Business
Business concerns participating in HUD Youth-build programs being carried out in the
metropolitan area in which the Section 3-covered assistance is expended.
Priority VI
Category 4a Business
Business concerns that are 51 percent or more owned by Section 3 residents in the metropolitan
area, or whose permanent, full-time workforce includes no less than 30 percent of Section 3
residents in the metropolitan area, or within three (3) years of the date of employment with the
business concern, were Section 3 residents in the metropolitan area.
Priority VII
Category 4b Business
Business concerns that subcontract in excess of 25 percent of the total amount of subcontracts to
Section 3 business concerns.
Eligibility for Preference
A business concern seeking to qualify for a Section 3 contracting preference shall certify or
submit evidence that the business concern is a Section business concern.
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SECTION 3 PARTICIPATION CERTIFICATION FOR BUSINESS CONCERNS SEEKING (Columbus Metropolitan Housing Authority)

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Completed 2 August 2021

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