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SAMTD/Marion Co. RFI/RFQ#00-08 10 <br />Private Development of Courthouse Square North Block <br />Has your firm been certified by the State of Oregon as a <br />Disadvantaged Business Enterprises? <br />Yes No <br />If yes, attach copy of current certification letter. <br />I hereby certify that the information provided on this form is true <br />and accurate to the best of my knowledge. <br />Signature: <br />Name & Title: <br />(Typed or Printed) <br />Date: <br />