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Contractor will submit this completed form with contract documents. <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 /> F.1: CERTIFICATION AS A MINORITY OWNED, WOMEN OWNED OR SECTION 3 BUSINESS <br /> 1 gr An � certify that ✓ M ( ) is / � is not <br /> a Minority Owned,Women Owned or Section 3 Business. r <br /> Business Registered Name <br /> �el <br /> Business Registered Address 1 <br /> rt <br /> State of Registration: <br /> Certificate or Registration Number: 6 77/5-�- <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 /> //�o 1,0V,25-- <br /> Printed Name; <br /> 1 <br /> Position: !'lll'1'le✓C1� �5 A4 e 4 <br /> 61 <br /> Page 1 of 2 <br />