Project Number: - ______________ List Information For Each Verified VSBE Prime Contractor or Subcontractor On This Project Name of Veteran-Owned Firm: DUNS Number: Description of work to be performed: Percentage of Total TOA: Name of Veteran-Owned Firm: DUNS Number: Description of work to be performed: Percentage of Total TOA: Name of Veteran-Owned Firm: DUNS Number: Description of work to be performed: Percentage of Total TOA: Name of Veteran-Owned Firm: DUNS Number: Description of work to be performed: Percentage of Total TOA: Continue on a separate page, if needed. SUMMARY TOTAL VSBE Participation: __________% I solemnly affirm under the penalties of perjury that the contents of this Affidavit are true to the best of my knowledge, information, and belief. ____________________________________ _____________________________________ Master Contractor Name Signature of Affiant (PLEASE PRINT OR TYPE) Name:_____________________________________ Title:______________________________________ Date:______________________________________ VSBE TORFP ATTACHMENT E-1B - Exhibit A VSBE Subcontractor Unavailability Certificate 1. It is hereby certified that the firm of (Name of Veteran-owned firm) located at (Number) (Street)
Project Number: - ______________ List Information For Each Verified VSBE Prime Contractor or Subcontractor On This Project Name of Veteran-Owned Firm: Percentage of Total TOA: DUNS Number: Description of work to be performed: Name of Veteran-Owned Firm: Percentage of Total TOA: DUNS Number: Description of work to be performed: Name of Veteran-Owned Firm: Percentage of Total TOA: DUNS Number: Description of work to be performed: Name of Veteran-Owned Firm: Percentage of Total TOA: DUNS Number: Description of work to be performed: Continue on a separate page, if needed. SUMMARY TOTAL VSBE Participation: __________% I solemnly affirm under the penalties of perjury that the contents of this Affidavit are true to the best of my knowledge, information, and belief. ____________________________________ _____________________________________ Master Contractor Name Signature of Affiant (PLEASE PRINT OR TYPE) Name:_____________________________________ Title:______________________________________ Date:______________________________________ VSBE TORFP ATTACHMENT E-1B - Exhibit A VSBE Subcontractor Unavailability Certificate 1. It is hereby certified that the firm of (Name of Veteran-owned firm) located at (Number) (Street)
VSBEParticipationE-FormsInstructions.docx