Section 3 Business Concern Certification for Contracting

Section 3 Business Concern Certification for Contracting Form

Instructions: Enter the following information and select the criteria that applies to certify your business’ Section 3 Business Concern status.

Business Information

Name of Business:(Required)

Address of Business(Required)

Street Address Address Line 2 City State ZIP Code

Name of Business Owner:(Required)

Phone Number of Business Owner:(Required)

Email Address of Business Owner:(Required)

Description of Business:(Required)

i.e. What services are offered?

Preferred Contact Information

Same as above

Same As Above

Name of Preferred Contact

Phone Number of Preferred Contact

Type of Business (select from the following options):(Required)

Corporation

Partnership

Sole Proprietorship

Joint Venture

Select from ONE of the following three options below that applies:(Required)

At least 51 percent of the business is owned and controlled by low- or very low-income persons (Refer to income guidelines HERE).

At least 51 percent of the business is owned and controlled by current public housing residents or residents who currently live in Section 8-assisted housing.

Over 75 percent of the labor hours performed for the business over the prior three-month period are performed by Section 3 workers (Refer to definition HERE).

Business Concern Affirmation

I affirm that the above statements (on the frontside of this form) are true, complete, and correct to the best of my knowledge and belief. I understand that businesses who misrepresent themselves as Section 3 business concerns and report false information to Albany Housing Authority may have their contracts terminated as default and be barred from ongoing and future considerations for contracting opportunities. I hereby certify, under penalty of law, that the following information is correct to the best of my knowledge.

Print Name:(Required)

Date(Required)

By clicking Submit your information will be sent to the AHA Procurement Department, and you will be redirected to the Become An AHA Vendor Form.