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<br /> <br />46 SECTION 2: MASTER AGREEMENT TERMS AND CONDITIONS | 2014_0122 <br /> <br />STATE OF MINNESOTA <br />VETERAN-OWNED PREFERENCE FORM <br /> <br />In accordance with Minn. Stat. § 16C.16, subd. 6a, (a) Except when mandated by the federal government as a condition of receiving <br />federal funds, the commissioner shall award up to a six percent preference in the amount bid on state procurement to certified small <br />businesses that are majority-owned and operated by: <br /> <br />(1) recently separated veterans who have served in active military service, at any time on or after September 11, 2001, and <br />who have been discharged under honorable conditions from active service, as indicated by the person's United States Department of <br />Defense form DD-214 or by the commissioner of veterans affairs; <br /> <br />(2) veterans with service-connected disabilities, as determined at any time by the United States Department of Veterans <br />Affairs; or <br /> <br />(3) any other veteran-owned small businesses certified under section 16C.19, paragraph (d). <br /> <br />In accordance with Minn. Stat. § 16C.19 (d), a veteran-owned small business, the principal place of business of which is in Minnesota, <br />is certified if it has been verified by the United States Department of Veterans Affairs as being either a veteran-owned small business or <br />a service disabled veteran-owned small business, in accordance with Public Law 109-461 and Code of Federal Regulations, title 38, <br />part 74. <br />_____________________________________________________________________________________________ <br /> <br />To receive a preference the veteran-owned small business must meet the statutory requirements above by the solicitation opening date <br />and time. The preference is applied only to the first $500,000 of the response. <br /> <br />If you are claiming the veteran-owned preference, attach documentation, sign and return this form with your response to the <br />solicitation. Only eligible veteran-owned small businesses that meet the statutory requirements and provide adequate documentation <br />will be given the preference. <br />_____________________________________________________________________________________________ <br /> <br />I HEREBY CERTIFY THAT THE FIRM LISTED BELOW: <br /> <br />My firm is a certified small business and it is majority-owned and operated by an eligible person as defined by Minn. Stat. § 16C.16, <br />subd. 6a. <br /> <br /> ___Yes ___No (must check yes or no) State the type of documentation attached:______________________________________ <br /> <br /> <br />DOCUMENTATION MUST BE PROVIDED FOR ONE OF THE FOLLOWING REQUIREMENTS: <br /> <br />___ (1) recently separated veterans who have served in active military service, at any time on or after September 11, 2001, and <br />who have been discharged under honorable conditions from active service, as indicated by the person's Unite d States <br />Department of Defense form DD-214 or by the commissioner of veterans affairs; <br /> <br />State the type of documentation attached: <br /> <br />___ (2) veterans with service-connected disabilities, as determined at any time by the United States Department of Veterans <br />Affairs; <br /> <br /> State the type of documentation attached: <br /> <br />___ (3) any other veteran-owned small businesses certified under Minnesota Statute Section 16C.19, paragraph (d). <br /> <br />State the type of documentation attached: <br /> <br />Name of Company: ________________________________ Date: _____________________________ <br /> <br />Authorized Signature: ________________________________ Telephone: _____________________________ <br /> <br />Printed Name: ________________________________ Title: _____________________________ <br /> <br />IF YOU ARE CLAIMING THE VETERAN-OWNED PREFERENCE, ATTACH DOCUMENTATION, SIGN AND RETURN THIS <br />FORM WITH YOUR RESPONSE TO THE SOLICITATION.