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DocuSign Envelope ID: 313DA256 -1 EDE- 4396- A716- 4C53B809027E <br />Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid <br />Identification of HUB Certified/ Minority Business Participation <br />I, H.M. Kern Corporation <br />(Name of Bidder) <br />do hereby certify that on this project, we will use the following HUB Certified/ minority business as <br />construction subcontractors, vendors, suppliers or providers of professional services. <br />Firm Name, Address and Phone # Work Type *Minority * *HUB <br />Category Certified <br />YIN <br />*Minority categories: Black, African American (B), Hispanic (H), Asian American (A) American Indian (1), <br />Female (F) Socially and Economically Disadvantaged (D) <br />** HUB Certification with the state HUB Office required to be counted toward state participation goals. <br />The total value of minority business contracting will be ($) <br />MBFornis 2002- Revised July 2010 <br />