2-Request for Goods Senior Center Vehicles 2026-09-ITB-017 - Legal Status.pdf
PDF 394 KB Posted
- Solicitation number
- 2026-09--IFB-017
- Issued by
- Tolland County, Connecticut
About this file
This is a Legal Status Disclosure form for the Town of Ellington, Connecticut, related to the Request for Goods Senior Center Vehicles #2026-09-ITB-017. The procurement seeks electronic bids for the purchase of two new vehicles for the Ellington Senior Center Transportation Program: one ADA-accessible wheelchair vehicle and one gasoline-powered crossover SUV. Bidders may submit pricing for either or both vehicles, with each vehicle to be evaluated and awarded separately in accordance with the specifications and contract documents provided. The disclosure form must be completed and submitted as part of the bid package to establish the bidder's legal status and authorization to conduct business.
The Legal Status Disclosure form requires bidders to provide comprehensive information regarding their business structure, including sole proprietorships, corporations, limited liability companies, or partnerships. Bidders must disclose their full legal name or corporate name, street and mailing addresses, years in business, and relevant officers, managers, or partners depending on their business entity type. The completed form must be dated and signed by an authorized representative of the bidding entity and notarized before a public official. This disclosure serves to verify bidder eligibility and ensure that the Town of Ellington has accurate information regarding the entities submitting bids for consideration and potential award.
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Text version
LEGAL STATUS DISCLOSURE
To the Town of Ellington:
RE: Request for Goods Senior Center Vehicles #2026-09-ITB-017
To the Town of Ellington:
The undersigned, having fully informed himself/herself/itself regarding the accuracy of the statements made herein, certifies that:
EMAIL ADDRESS: _________________________________________________
IF A SOLELY OWNED BUSINESS:
Bidder’s Full Legal Name: _________________________________________
Street Address: __________________________________________________
Mailing Address (if different): ______________________________________
Number of years engaged in business under sole proprietor: _______________
IF A CORPORATION:
Bidder’s Corporate Name: _________________________________________
Street Address: __________________________________________________
Mailing Address (if different): ______________________________________
Number of years engaged in business: ________________________________
Name of current officers:
Secretary ______________________________
President ______________________________
IF A LIMITED LIABILITY COMPANY:
Bidder’s Company Name: _________________________________________
Street Address: __________________________________________________
Mailing Address (if different): ______________________________________
Number of years engaged in business: ________________________________
Name and address of current managers/members:
IF A PARTNERSHIP:
Bidder’s Partnership Name: ________________________________________
Street Address: __________________________________________________
Mailing Address (if different): ______________________________________
Number of years engaged in business: ________________________________
Name and address of current partners:
The undersigned bidder further certifies that this disclosure is executed for the purpose of inducing the Town of Ellington to consider its bid and make an award in accordance therewith.
DATED: ___________________, 2026.
BIDDER:
By______________________________
SUBSCRIBED and sworn to before me this _____ day of ________________, 2026.
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