4-Attachment F - URS Post-Retired Verification Form.pdf
PDF 134 KB Posted
- Attached to
- IFB - Video Wall for Bingham High School
- Solicitation number
- 27CA01
- Issued by
- Salt Lake County, Utah
About this file
This is a verification form attachment related to an Invitation for Bid (IFB) for a Video Wall at Bingham High School issued by the Jordan School District in Utah. The document serves as Attachment F to the IFB and is titled the "URS Post-Retired Verification Form," indicating it is used to verify the post-retirement status of individuals in connection with the bidding process. The form is part of the contractual documentation required for bidders to demonstrate compliance with applicable state procurement regulations under the Utah Code Annotated (UCA) Chapter 63G-6a and Utah Administrative Rules (UAR). The IFB will be awarded to the lowest responsive and responsible bidder, with the awarded bidder receiving notice to proceed in the form of a Purchase Order from the JSD Purchasing Department.
The specific requirements and procedures outlined in the URS Post-Retired Verification Form ensure that bidders meet all eligibility criteria established by the Jordan School District and the State of Utah. This verification form is essential to the responsiveness determination process, as failure to meet the requirements stated in the full IFB attachments—including proper completion of this form—may result in a bid being deemed non-responsive. The Jordan School District Purchasing Department retains the discretionary authority to reject any or all proposals and to waive any informality or technicality in proposals as deemed in the best interest of the district.
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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 .