Attachment 3 - Form W-14.pdf

This is Form W-14, "Certificate of Foreign Contracting Party Receiving Federal Procurement Payments," which is required for foreign contractors receiving payments from U.S. federal agencies. The form is part of solicitation 19GE5025R0003 for health insurance services at the U.S. Embassy in Georgetown, Guyana.

The form requires foreign contractors to provide identification information, permanent residence address, U.S. taxpayer ID (if any), and details about tax exemptions based on international agreements. It includes sections for claiming relief under section 5000C tax treaties, reporting exempt and nonexempt amounts related to goods/services produced in the U.S., and explaining the basis for any claimed exemptions. The form is marked as "SENSITIVE BUT UNCLASSIFIED" and must be submitted to the acquiring agency, not the IRS. This is a standard required form (OMB No. 1545-2269) that foreign contractors must complete to receive federal procurement payments.