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North Central Texas Regional Certification Agency

624 Six Flags Drive, Suite 216

Arlington, Texas 76011

THIS APPLICATION IS FOR MBE OR WBE CERTIFICATION, PLEASE CIRCLE THE TYPE OF CERTIFICATION YOU ARE SEEKING
minority business enterprise

(mbe)

Complete this application and submit all required documentation

    A business which is at least 51% owned, managed and the daily business operations controlled by one or more minority individuals.  Minority generally includes the following groups:  American Indians, Aleuts, Asian-Pacific Americans, Black Americans, Eskimos, Hispanic Americans, Native Hawaiians and Subcontinent Asian Americans.

woman business enterprise

(wbe)

Complete this application and submit all required documentation

    A business which is at least 51% owned, managed and the daily business operations controlled by one or more women owners.

IF YOU ARE SEEKING DBE CERTIFICATION, PLEASE STOP AND COMPLETE A DBE CERTIFICATION APPLICATION
disadvantaged business enterprise
(dbe)

Complete the DBE application, submit all required documentation and the PNW form that is available on the NCTRCA website

    A small business which is at least 51% owned, managed and the daily business operations controlled by one or more minorities and/or women.  Minority generally includes the following groups:  American Indians, Aleuts, Asian-Pacific Americans, Black Americans, Eskimos, Hispanic Americans, Native Hawaiians and Subcontinent Asian Americans.

You must also complete a Personal Net Worth (PNW) form to submit with the DBE application and its required documentation.

    DBE certification is required by public agencies on contracts financed in whole or in part with federal funds.  Prime contractors seeking to meet DBE subcontracting goals will seek to identify firms certified as DBEs instead of MBEs or WBEs.  Potential subcontracting opportunities may be missed if DBE certification is not obtained. The decision to pursue a DBE certification, instead of MBE or WBE, is a business decision that you, the applicant, must make.      

GENERAL BUSINESS INFORMATION

1.

Business Name

Owner's Name

Telephone Number

Fax Number

Mobile/Cell Number

E-mail address

Internet Website / URL Address

2.

Does this business use any other name(s)?

Yes_____ No_______

If yes, indicate name(s)

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