7101123106Certificate.pdf
PDF 68 KB Posted
- Contract number
- Security Guard Services (Statewide) and Fire Safety and Emergency Action Plan Directors (Region 1 – NYC Only)
- Issued by
- New York
About this file
This document is Attachment 5 - Certificate of Compliance for Group 71011, a New York State Office of General Services statewide contract covering Security Guard Services and Fire Safety/EAP Directors (limited to Region 1 - NYC only). The certificate serves as a compliance verification form that contractors must file with authorized users and maintain copies of when providing security personnel under this state contract vehicle.
The contract covers security guard services at Level I and Level II classifications, as well as Fire Safety/Emergency Action Plan (EAP) Directors specifically for New York City facilities. The certificate requires contractors to verify that assigned security personnel meet all qualification requirements, including valid NYS Department of State registration numbers with issue dates and NYC Fire Department Certificate of Fitness dates where applicable. The form includes notarization requirements and specific attestation language for different business entity types (corporations, partnerships, and limited liability companies), ensuring proper authorization and compliance with contract terms before personnel deployment at specified facilities.
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Other files
| File | Type | Posted |
|---|---|---|
| 7101123106PricingSummary.xlsx | XLSX spreadsheet | |
| 7101123106Amendment3.pdf | ||
| 7101123106AppendixA.pdf | ||
| 7101123106RFQInstructions.docx | DOCX document | |
| 7101123106Amendment2.pdf | ||
| 7101123106RFQForm.docx | DOCX document | |
| 7101123106AppendixC.pdf | ||
| 7101123106pm.pdf | ||
| 7101123106AppendixB.pdf | ||
| 7101123106ra.pdf | ||
| 7101123106Amendment1.pdf | ||
| 7101123106ContractUsage.xlsx | XLSX spreadsheet | |
| 7101123106MAP_ML.xlsx | XLSX spreadsheet | |
| 7101123106Insurance.pdf | ||
| 7101123106BaseContract.pdf | ||
| 7101123106HTUandFAQ.pdf |
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Text version
Group 71011 - Security Guard Services (Statewide) and Fire Safety/EAP Directors (Region 1 - NYC only) Page 1 of 1
7101123106_CertofCompliance113018
Attachment 5 - Certificate of Compliance
(To be filed with the Authorized User and a copy maintained by Contractor)
I, ____________________________, have reviewed all of the terms and conditions of the New York State Office of General
Services’ Security Guard and Fire Safety/EAP Directors Contract with a Contract Number of __________________ as well as the Request for Quotes (RFQ) issued by _________________________________ (Authorized User Name) for the Facility with an address of _____________________________ prior to assigning and/or directing a Security Guard and/or Fire Safety/EAP
Director to provide services at the specified Level thereunder.
I certify, under the penalty of perjury, that the Security Guard and/or Fire Safety/EAP Director with the name of
____________________, NYS Department of State Registration No.____________ Issue Date________ and/or NYC Fire
Department Certificate of Fitness Date _________________ meets all of the qualifications required for the position of a Level I, Level II, Fire Safety/EAP Director (CIRCLE ONE) as requested by the Authorized User in its RFQ dated _____________ for assignment at the Facility with the name of_____________________, and also meets the requirements as set forth in the above-referenced OGS Security Guard and Fire Safety/EAP Director Contract.
Dated: ___________________________
Printed Name _________________________________
Signature _____________________________________
Contractor _____________________________________
(☐ If a corporation): _he is the ____________________________________of____________________________, the corporation described in said instrument; that, by authority of the Board of Directors of said corporation, _he is authorized to execute the foregoing instrument on behalf of the corporation for purposes set forth therein; and that, pursuant to that authority, _he executed the foregoing instrument in the name of and on behalf of said corporation as the act and deed of said corporation.
(☐ If a partnership): _he is the ____________________________________of____________________________, the partnership described in said instrument; that, by the terms of said partnership, _he is authorized to execute the foregoing instrument on behalf of the partnership for purposes set forth therein; and that, pursuant to that authority, _he executed the foregoing instrument in the name of and on behalf of said partnership as the act and deed of said partnership.
(☐ If a limited liability company): _he is a duly authorized member of ___________________________, LLC, the limited liability company described in said instrument; that _he is authorized to execute the foregoing instrument on behalf of the limited liability company for purposes set forth therein; and that, pursuant to that authority, _he executed the foregoing instrument in the name of and on behalf of said limited liability company as the act and deed of said limited liability company.
Signed this
______day of___________, 20__
Notary Public Name: __________________________________
State: ____________________________
New York State Notary Number: _____________________________
File details come from the government source that posted it. Updated .