attachment-4-bid-2614-23.pdf

PDF 70 KB Posted

Attached to
Contract: Fuel, Gasoline and Diesel (On-Road Premium)
Solicitation number
Bid 2614-23
Issued by
Belknap County, New Hampshire

About this file

This is a Federal Excise Tax Exemption Certificate issued by the State of New Hampshire's Bureau of Purchase and Property for fuel products procured through various state contracts and purchase orders. The certificate, executed by Gary Lunetta, Administrator of the Bureau of Purchase and Property, authorizes tax-exempt purchases of fuel products—specifically gasoline, diesel, and kerosene—for the exclusive use of all State of New Hampshire agencies. The exemption certificate number is 02-73-0112K and is dated November 15, 2022. The certificate applies to fuel products covered under contracts and purchase orders issued by the State of New Hampshire and specifies that the purchased articles are for the exclusive use of state agencies only.

The certificate establishes that the State of New Hampshire waives any right to claim credits or payments for gasoline, diesel, or kerosene fuel covered under this exemption. The document includes penalties for fraudulent use, which carry fines of up to $10,000, imprisonment of up to five years, or both, plus prosecution costs. The certificate further stipulates that if any tax-free articles are used for purposes other than state agency operations or are sold to employees or third parties, such misuse must be reported to the article manufacturer. This exemption certificate provides the State of New Hampshire with federal excise tax relief on fuel purchases essential to state operations across all agencies.

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Other files

File Type Posted
bid-2614-23.pdf PDF
attachment-2-bid-2614-23.pdf PDF
attachment-3-bid-2614-23.pdf PDF
attachment-1-bid-2614-23.xlsx XLSX spreadsheet
bid-2614-23-award.pdf PDF
addendum-1-bid-2614-23.pdf PDF

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Text version

SAMPLE

Federal Excise Tax

EXEMPTION CERTIFICATE

(FOR USE BY THE UNITED STATES, TERRITORIES, OR POLITICAL DIVISIONS THEREOF, OR THE DISTRICT OF COLUMBIA)

November 15, 2022

The undersigned hereby certifies that he is the Administrator, Bureau of Purchase and Property of the

State of New Hampshire, and that he is authorized to execute this Certificate, and that the article or articles specified below are purchased from VENDOR NAME for the exclusive use of All State Agencies of the State of New Hampshire.

It is understood that the exemption from tax in the case of all sales or articles under this Exemption

Certificate to the United States, Territories, etc. is limited to the sale of articles purchased for their exclusive use, and it is agreed that if articles purchased tax-free under this Exemption Certificate are used otherwise, or are sold to employees or others, such fact must be reported to the manufacturer of the article or articles covered by this Certificate. It is also understood that the fraudulent use of this

Certificate to secure exemption will subject all guilty parties to a fine of not more than $10,000, or to imprisonment for not more than five years, or both, together with cost of prosecution.

State of New Hampshire acknowledges that it has not and will not claim any credit or payment for the gas, diesel fuel to which this certificate relates.

State of New Hampshire acknowledges that by signing this certificate, the State of New Hampshire gives up its right to claim any credit or payment for the Gasoline, Diesel, or Kerosene fuel to which this certificate relates.

Gary Lunetta, Administrator

Bureau of Purchase & Property

This Exemption Certificate covers the following articles specified in various Contracts and Purchase

Orders issued by the State of New Hampshire for FUEL PRODUCTS.

EXEMPTION CERTIFICATE# 02-73-0112K

File details come from the government source that posted it. Updated .