This page was read by OCR. Text can misread numbers, dates or table columns. Check the PDF before quoting or interpreting it. Redacted areas remain redacted.
Contractor’s License: Class A Class B Class C
Certifications: SWaM DBE Other:
[hereby certify to the US Department of Housing and Urban Development (HUD) that all of the information on
this form is true and correct. I attest under penalty of perjury that my business meets that elected definition and
understand proof of this information may be requested. I understand, if found to be inaccurate, I may be
disqualified to be classified as a certified Section 3 business.
Signature of Business Owner or Authorized Representative Date
Notary Public Jurist: City/County of in the Commonwealth of Virginia
The foregoing instrument was subscribed and sworn before me thus day of , 20 by:
Notary (Print Name) Notary Signature
The commission expires: Notary Registration Number:
Marshall Courts Phase VI Demolition
IFB#MCP7D-09-24 ATTACHMENT “J”
Page 7 of 11Jump to an indexed page (88 of 88)