3-Attachment F - URS Post-Retired Verification Form.pdf
PDF 134 KB Posted
- Attached to
- IFB - Tableau Software Licenses
- Solicitation number
- 27TH08
- Issued by
- Utah
About this file
This is a URS Post-Retired Verification Form attachment associated with Jordan School District's Invitation for Bid (IFB) for Tableau Software Licenses issued in accordance with the State of Utah Procurement Code. The document serves as a verification form for retired individuals applying for or renewing contracts with the district. While specific details regarding quantities, response dates, site visits, or bidder meetings are not evident from this attachment alone, the form is part of the comprehensive bidding documentation governing the procurement process. The contract will be awarded and administered in compliance with Utah Code Annotated Chapter 63G-6a and applicable Utah Administrative Rules.
The URS Post-Retired Verification Form functions as a compliance and verification document ensuring that bidders or their key personnel meet retirement status requirements as may be applicable under Utah retirement system regulations. This form is typically used to verify an individual's post-retirement status and may be relevant to certain contractor qualifications, affiliation requirements, or other procurement-related criteria established by Jordan School District. Additional pricing terms, set-asides, funding sources, and specific contract requirements would be detailed in the primary IFB documentation and supporting exhibits not contained within this specific attachment.
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Text version
Name
Business Name
Have you (or the contractor, owner, partner, or principal) retired from
Utah Retirement Systems (URS)?
No *Yes
*If you answered yes:
*Provide your birthdate _________________ (required)
*Type of business you provide _______________________________ (required)
Signature Date
Please submit this form along with the W-9 to the Accounting Department.
Retirees receiving a monthly benefit from URS have restrictions when returning to work. Re-employment includes work or service performed as an employee (paid through Payroll) OR on a contract (as a business or independent contractor paid through Accounting) for a participating URS employer if the retiree is listed as the contractor, owner, partner, or principal of the contractor (business).
If it is discovered that a URS retiree failed to report reemployment to URS on its Post-
Retirement Employment form (Form RTRT-27A) in violation of Title 49, the retiree will be liable to repay URS the amount of any overpayment resulting from the violation to report. See Utah code section 49-11-1207(2).
*The retiree is directed to contact URS's Retirement Benefits Department at 801-
366-7770 before beginning work with Jordan District. You will be asked to complete and file a Post-Retirement Employment form (Form RTRT-27A).
URS Post-Retired Verification
Independent Contractors (1099 Employees)
File details come from the government source that posted it. Updated .