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EXHIBIT 6 <br />City of Santa Ana <br />Section 3 Business Concern Eligibility Certificate <br />Name of Business: % 11 C, <br />Address of Business: -/ /' (�O G Q `�rN U �(� A eft e L �¢il/ <br />Telephone Number: _/I7— 99iz"fry Fax Number: %/0—.7-7? 00�� <br />Type of Business: IJ Corporation []Partnership <br />❑Sole Proprietorship ❑Joint Venture <br />Section 3 Business Concern Qualifying Basis <br />1 • 51 % owned by Section 3 low-income residents; or <br />2•_Permanent, full-time employees that include at least 30% Section 3 low-income or very low- <br />income residents; or <br />3•___ Written commitment to subcontract with more than 25 % of the dollar award of all subee nstract <br />to be awarded to business concern($) that meet either of the above (1 or 2) Section 3 <br />qualifications. <br />Specify Ethnicity and Gender of Business Ownership (please check one); <br />❑ American Indian or Alaska Native <br />❑ Native Hawaiian or Other Pacific Islander <br />❑ American Indian or Alaska Native and White <br />❑ Black or African American and white <br />❑ American Indian or Alaska Native and Black or African American <br />❑ Balance of Individuals reporting more than one race <br />Gender: <br />Male ❑ Female <br />❑ Asian <br />❑ White <br />❑ Asian and White <br />❑ Black or African American <br />By this signature affixed hereto, I declare r penalty of perjury that the above information is correct. <br />Print Name <br />�� — <br />e Date <br />