Attachment 5 Affidavit of Compliance with tax laws~5.pdf
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- Attached to
- ITB for Roof Maintenance and Repair in Eugene
- Solicitation number
- S-47100-00015307
- Issued by
- Lane County, Elmira CDP, Oregon
About this file
This file is an Affidavit of Compliance with Tax Laws form required for the Invitation to Bid (ITB) S-47100-00015307 for roof maintenance and repair services at the State of Oregon, Employment Department (OED) Eugene Field Office. The affidavit serves as a compliance document that bidders must complete and submit as part of their bid package. The form requires an authorized representative of the bidding entity to attest under penalty of perjury to their eligibility and tax compliance status. Bidders must provide either a Federal Tax Number or Social Security Number and confirm that they are not subject to IRS backup withholding or have been notified by the IRS that they are no longer subject to such withholding.
The affidavit requires bidders to certify their compliance with all applicable Oregon tax laws, including those outlined in ORS 305.380(4), which encompasses Oregon Revenue and Taxation Code chapters 118, 314, 316, 317, 318, 320, 321, and 323, as well as sections 10 to 20 of Chapter 533, the elderly rental assistance program, and any local taxes administered by the Oregon Department of Revenue. The affidavit must be signed by the authorized representative and notarized before a notary public. This document is essential for bid submission and verifies that the bidder maintains compliance with all state and local tax obligations prior to contract award.
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Text version
ITB S-47100-00015307 – Eugene Roof Maintenance and Repair
Page 53/60
ATTACHMENT 5
AFFIDAVIT OF COMPLIANCE WITH TAX LAWS
State of ________________ ss County of ______________
____________________________________ (Affiant), on behalf of _____________________________ (hereafter “Bidder”), hereby attests under penalty of perjury that:
1. I am an authorized representative of the Bidder, and I have full authority from the Bidder to submit this affidavit and accept the responsibilities stated herein.
2. I am aware that the Bidder has submitted a bid, and I am familiar with the contents of the Invitation to Bid and the bid.
3. The number shown below is Bidder's correct taxpayer identification. (Provide one of the following identification numbers):
a. Federal Tax Number: __________________
b. Social Security Number: ________________
4. Bidder is not subject to backup withholding because (a) Bidder is exempt from backup withholding,
(b) Bidder has not been notified by the IRS that Bidder is subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified Bidder that Bidder is no longer subject to backup withholding.
5. I have knowledge regarding Bidder's payment of taxes, and to the best of my knowledge, Bidder is not in violation of any Oregon tax laws, including, without limitation, those tax laws listed in ORS 305.380(4), namely ORS Chapters 118, 314, 316, 317, 318, 320, 321 and 323 and Sections 10 to 20, Chapter 533, the elderly rental assistance program under ORS 310.630 to 310.706, and any local taxes administered by the Oregon Department of Revenue under ORS 305.620; and Application of penalties, misdemeanors and jeopardy assessment; employer as taxpayer under ORS 316.212, Tax on centrally assessed, mercantile, manufacturing and business corporations and financial institutions under ORS 317.070, Payment of tax; returns; estimated tax; payment under ORS 321.045, Audit of returns; interest and penalties upon failure to file return or pay tax under ORS 321.560, penalty for nonpayment of credit purchase; interest under ORS 323.195, extension of time for reports and payment of tax; interest under ORS 323.365, and Failure to pay tax or timely file report under ORS 323.381.
Affiant’s Signature: ___________________________________
Signed and affirmed to before me on _________________ by ______________________________.
(Date) (Affiant’s Name)
Notary Signature: ____________________________________
Notary Public for the State of ____________________________
My Commission Expires: _______________________________
File details come from the government source that posted it. Updated .