Self-certification of minority-owned and/or women-owned business status for federal, state, and local procurement programs per 49 C.F.R. Part 26 and SBA 8(a)/WOSB/EDWOSB eligibility.
📄 1 signer📅 30-day expiry🏷 Government & Public🔖 mwbe, minority-owned, women-owned, dbe, small-business, certification, government
About this template
The Minority / Women-Owned Business Certification is a ready-to-use government & public template you can send for signature in minutes. It is written for 1 signer (owner) and, by default, expires 30 days after it is sent if left unsigned. It covers mwbe, minority owned, women owned, dbe, small business, certification. Like every Abundera Sign template it is a convenience draft structured for ESIGN Act and UETA compliance, not a substitute for legal advice. Each signed copy is sealed with PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package in WORM storage.
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# Minority / Women-Owned Business Certification ## Applicable Programs and Legal Authority Minority-owned and women-owned business certifications are governed by multiple overlapping federal programs: - **49 C.F.R. Part 26** — Participation by Disadvantaged Business Enterprises (DBE) in Department of Transportation financial assistance programs - **SBA 8(a) Business Development Program** — 13 C.F.R. Part 124 — for socially and economically disadvantaged small businesses - **Women-Owned Small Business (WOSB) Federal Contracting Program** — 13 C.F.R. Part 127 — 15 U.S.C. § 637(m) - **Economically Disadvantaged Women-Owned Small Business (EDWOSB)** — subset of WOSB with additional economic disadvantage criteria - **HUBZone Program** — 13 C.F.R. Part 126 — for businesses in historically underutilized business zones - State and local programs, which vary by jurisdiction Complete this form carefully. Misrepresentation of eligibility in connection with federal procurement is a federal offense. --- ## Part 1 — Applicant and Business Information **Business Legal Name:** ___________ **Doing Business As (DBA), if applicable:** ___________ **Entity Type:** ___________ **Date Business Established:** ___________ **Federal Employer Identification Number (EIN):** ___________ **Primary NAICS Code:** ___________ **Annual Gross Revenue — Prior Fiscal Year:** ___________ **Number of Full-Time Employees:** ___________ **Number of Part-Time Employees:** ___________ --- ### Business Address