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DocuSign Envelope ID:98CAB32E-1814-4C97-B61E-B14BE79B81EA <br /> Attach to laid Attach to[lid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Rid Attach to Rid <br /> Identification of HUB Certified/ Minority Business Participation <br /> 1, F5 c 1),uL ��k Fu--o C'm IT'f A�.Y <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 /> Y/NJ <br /> / rx ;ice- Sce✓,c—� <br /> W05- tt.{ r Rom. AW64 VL 274#6 <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 /> OD <br /> The total value of minority business contracting will be <br /> MBFornis 2002-Revised July 2010 <br />