Section 3 - Business and Contractors
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Business Self Certification

These forms are for businesses who are seeking to identify themselves as a Section 3 business to uncover their Section 3 status. Businesses or contractors seeking to be considered a Section 3 business directly for PRDOH should use the PRDOH self certification form.

Certificación de Negocio EN

Basic Business Information

Address of Business
Address of Business
City
State
Zipcode
Business Type
*Supporting documentation must be provided as an attachment to this form, otherwise this form alone is not sufficient for evaluation of your Section 3 Business Concern status. A minimum of one documentation should be provided for Evidence of business ownership.

Section 1: Business Ownership

If the primary owner(s) of the business is/are Section 3 Residents, complete sections 1A and 1B below. Attach documents as needed.

1A. Business Ownership
AND
1B. Evidence of Business Ownership ( I am attaching the following: )

Section 2: Employees of the Business

If the business qualifies as Section 3 Business Concern due to thirty percent (30%) of full-time employees being Section 3 Residents, complete Sections 2A and 2B below.

2A Employees for the Business

Employees
2B Evidence of Employees of the Business

Section 3: Subcontracting

If the business concern meets Section 3 Business Concern requirements through subcontracting goals, complete Sections 3A and 3B below.

3A Subcontracting
3B Evidence of Subcontracting
1. Business names, addresses, and points of contact information.
2. List of all awarded contracts and subcontracts with brief Scope of Work and total dollar amounts identified.
3. Subcontract amount for Section 3 Business (at least twent-five percent (25%)).
4. All subcontractor’s Section 3 certifications and evidence of being a Section 3 Business.
5. Signatures of both business representatives attesting to truthfulness of information provided.
3B Evidence of Subcontracting
1. Proposed Business names, addresses, and point of contact information
2. List of services you intend to subcontract and brief intended Scope of Work and dollar amounts identified
3. Affirm the subcontract amount for the Section 3 Business (at least twenty-five percent (25%))
4. All subcontractor’s Section 3 certification and evidence of being a Section 3 Business
5. Signatures of both business representatives attesting to truthfulness of information provided.

Section 4: Signature

Checkboxes
Checkboxes
Checkboxes
Checkboxes
I will have no more than thirty (30) calendar days from the date of submission to provide all requisite paperwork.
Once the thirty (30) days period passed, PRDOH will dismiss all self-certifications forms deemed incomplete, if not completed by the contractor.
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