5-Form Certification-of-Financial-Condition 09.2021.pdf
PDF 142 KB Posted
- Attached to
- Artificial Turf Putting Green State and local contract opportunity
- Solicitation number
- 59-Q6923
- Issued by
- Guilford County, North Carolina
About this file
This document is a Certification of Financial Condition form issued by North Carolina for use in state and local contract solicitations. The form requires vendors to certify their financial standing across multiple criteria, including whether the company maintains sound financial condition with current audit opinions, possesses no outstanding liabilities to the Internal Revenue Service or other government entities, remains current on federal and state tax payments and employment-related contributions, and is not subject to current or past litigation or noncompliance findings under federal or state law. The certification applies to the North Carolina A&T artificial turf putting green project within the Aggie Dome, which aims to install a high-performance training surface for the university's athletic programs.
Vendors completing this certification must authorize an individual with appropriate authority to execute the form and must provide explanations for any boxes left unchecked. The form constitutes a continuing certification, requiring vendors to notify the contract lead within 30 days of any material changes to the representations made. If an audit has not been conducted within the preceding 18 months, vendors must explain the reason for this gap. Failure to provide adequate explanations for unchecked boxes may result in the vendor's submission being deemed non-responsive and rejected in its entirety.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 3-Form North Carolina General Terms and Conditions 11 2023.pdf | ||
| 7-RFQ-59-6923 Artificial Turf.pdf | ||
| 1-North Carolina Instructions to Vendors - 7-10-2023 - eVP go-live version.pdf | ||
| 2-Form HUB-Supplemental-Vendor-Information 9.2021.pdf | ||
| 6-Form Vendor-Price-Matching-Opportunity 09.2021.pdf | ||
| 4-PC Form Customer Reference Template 09.2021 Attachment E.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
North Carolina Certification of Financial Condition Version Date: 09/2021
Page | 1
ATTACHMENT G: CERTIFICATION OF FINANCIAL CONDITION
Solicitation #: __________________________
Vendor Name: __________________________
The undersigned hereby certifies that: [check all applicable boxes]
☐ The Vendor is in sound financial condition and, if applicable, has received an unqualified audit opinion for the latest audit of its financial statements.
Date of latest audit: ____________________ (If no audit within past 18 months, explain reason below.)
☐ The Vendor has no outstanding liabilities, including tax and judgment liens, to the Internal Revenue Service or any other government entity.
☐ The Vendor is current in all amounts due for payments of federal and state taxes and required employment-related contributions and withholdings.
☐ The Vendor is not the subject of any current litigation or findings of noncompliance under federal or state law.
☐ The Vendor has not been the subject of any past or current litigation, findings in any past litigation, or findings of noncompliance under federal or state law that may impact in any way its ability to fulfill the requirements of this Contract.
☐ He or she is authorized to make the foregoing statements on behalf of the Vendor.
Note: This shall constitute a continuing certification and Vendor shall notify the Contract Lead within 30 days of any material change to any of the representations made herein.
If any one or more of the foregoing boxes is NOT checked, Vendor shall explain the reason(s) in the space below. Failure to include an explanation may result in Vendor being deemed non-responsive and its submission rejected in its entirety.
Signature Date
Printed Name Title
[This Certification must be signed by an individual authorized to speak for the Vendor]
ATTACHMENT G: CERTIFICATION OF FINANCIAL CONDITION
| Solicitation: |
| Vendor Name: |
| The Vendor is in sound financial condition and if applicable has received an unqualified audit: Off |
| The Vendor has no outstanding liabilities including tax and judgment liens to the Internal Revenue: Off |
| The Vendor is current in all amounts due for payments of federal and state taxes and required: Off |
| The Vendor is not the subject of any current litigation or findings of noncompliance under federal or: Off |
| The Vendor has not been the subject of any past or current litigation findings in any past litigation: Off |
| He or she is authorized to make the foregoing statements on behalf of the Vendor: Off |
| If no audit within past 18 months explain reason: |
| 1: |
| Date: |
| Printed Name: |
| Title: |
File details come from the government source that posted it. Updated .