WBENC Certification

WBENC CERTIFICATION

RECITALS

WHEREAS, Applicant Business Name: (the "Applicant") seeks certification as a Women's Business Enterprise for the purposes of supplier diversity, contracting, and related business development activities; and

WHEREAS, Certifying Organization Name: (the "Certifier") administers certification pursuant to established standards requiring that a business be at least fifty-one percent (51%) owned, controlled, operated, and managed by one or more women who are U.S. citizens or lawful permanent residents; and

WHEREAS, the Applicant represents that the information and documentation submitted in support of this application are true, accurate, and current, and that Applicant agrees to comply with the certification procedures, fee terms, and post-certification monitoring obligations set forth herein.

BUSINESS INFORMATION

OWNERSHIP AND CONTROL

Is the business at least fifty-one percent (51%) owned and controlled by one or more women?   Yes   No

Entity Type:   Sole Proprietorship   Partnership   Corporation   LLC   Other

SCOPE OF CERTIFICATION

Describe the nature of business, primary goods and/or services, and NAICS or industry codes to be covered by certification.

SUPPORTING DOCUMENTATION (CHECK ALL THAT APPLY)

Articles of Incorporation / Formation Documents
Operating Agreement / Partnership Agreement
Proof of Ownership (stock ledgers, membership certificates)
Resumes of Key Officers / Owners
Financial Statements (as provided)

PAYMENT TERMS

Applicant agrees to pay the application and certification fees in accordance with Certifier's fee schedule. Application Fee: $

Late Fee: on overdue balances. Applicant acknowledges responsibility for collection costs and interest as permitted by law.

TERM AND TERMINATION

Certification Period Commencement Date: and Expiration Date: unless earlier suspended or revoked in accordance with this Agreement.

Either party may terminate this Agreement for cause upon written notice of material breach and failure to cure within days. Termination for convenience by the Certifier may occur in accordance with Certifier policy; Applicant acknowledges refund policies are discretionary.

CONFIDENTIALITY

The Certifier will maintain information designated as confidential by the Applicant in confidence to the extent permitted by law and consistent with its obligations to government stakeholders and program participants. Applicant expressly understands that certain information submitted for certification may be shared with authorized contracting entities, auditors, and regulatory bodies for verification and compliance purposes. Notwithstanding the foregoing, the Certifier is not liable for disclosure required by law or court order.

GOVERNING LAW

This Agreement and the certification granted hereunder shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of law principles. Venue for disputes arising from this Agreement shall lie in the state or federal courts located within that state.

ENTIRE AGREEMENT

This Certification Agreement, together with the application, attachments, and any fee schedule executed or incorporated by reference, constitutes the entire agreement between Applicant and Certifier with respect to certification and supersedes all prior or contemporaneous oral or written representations, agreements, or understandings. No modification of this Agreement will be effective except in writing signed by an authorized representative of Certifier and Applicant.

ATTESTATION

I certify, under penalty of perjury, that I am duly authorized to execute this certification on behalf of the Applicant; that the Applicant meets and will continue to meet all eligibility criteria for WBENC certification including ownership, control, and management requirements; and that the information and documentation provided to the Certifier are true, accurate, and complete to the best of my knowledge. I acknowledge that willful misrepresentation may subject the Applicant to denial, suspension, or revocation of certification and other penalties permitted by law.

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