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BielderlResponelent will submit <br /> this completed document with <br /> w a��w a.����. <br /> Not Applicable awl/flr <br /> EXHIBIT SC <br /> MBE/WBE/Section 3 <br /> Instructions: If the Respondent/Bidder is a Minority Owned Business (MOB) or Women Owned Business (WOB) <br /> or qualifies as a Section 3 business, the Respondent completes Form F.1., and if the Respondent/Bidder intends <br /> to utilize a MOB/WOB or Section 3 business in the performance of the proposed contract, the respondent <br /> /bidder completes Form F.2 <br /> A u Y /"" 0 N)1,4& t 11)M \N0 M 11 0\A)1',,,1 11 t 11) 01,,"\ <br /> I, certify that ( ) is / ( ) is not <br /> a Minority Owned,Women Owned or Section 3 Business. <br /> Business Registered Name <br /> Business Registered Address 1 <br /> State of Registration: <br /> Certificate or Registration Number: <br /> Certifying Agency: <br /> This certification is a material representation of fact upon which reliance was placed when this transaction was <br /> made or entered into. The City reserves the right to withdraw or terminate the proposed contract should the <br /> representation of fact be false. <br /> Signature and Date: <br /> Printed Name: <br /> Position: <br /> Page 1 of 2 <br />