Attachment B_PERA Certification.pdf
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- Solicitation number
- RFP GMAA 2026000162 3
- Issued by
- Denver County, Denver City, Colorado
About this file
This is a PERA Certification and Affidavit form required for the Colorado student housing property management services contract AHEC-26915-R. The form serves as a compliance document for vendors participating in state contracting and requires vendors to make sworn declarations regarding their relationship to Public Employees' Retirement Association (PERA) retirees under Colorado Revised Statutes 24-51-1101(2), 24-51-401, and related provisions. Vendors must certify their PERA retiree status if they are sole proprietors or individuals, disclose whether a PERA retiree owns 5% or more of the company, specify if the company employs a PERA retiree and quantify the percentage of contract value attributable to such employment, and declare whether the company is affiliated with or profits from services performed by PERA retirees.
The certification requires completion by an authorized representative of the vendor through signature and must be executed under penalty of perjury under Colorado law. The form includes blank fields for the vendor's full legal name, FEIN or Social Security Number, the authorized representative's signature and title, and the date of certification. This document is a mandatory compliance requirement for all bidders on the AHEC-26915-R contract and must be submitted as part of the bid package to verify adherence to Colorado's PERA-related contracting regulations.
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Text version
ATTACHMENT B - AHEC-26915-R
CERTIFICATION AND AFFIDAVIT
REGARDING PERA RETIREES
The Vendor, whose name and signature appear below, certifies and agrees as follows:
1. If the Vendor is a sole proprietor or individual, the undersigned hereby swears or affirms under penalty of perjury under the laws of the State of Colorado that (check one):
____ I am a PERA retiree, or
____ I am not a PERA retiree
2. The Vendor shall comply with the provisions of 24-51-1101(2) C.R.S. The undersigned hereby swears or affirms under penalty of perjury under the laws of the State of Colorado that (check one):
____ A PERA retiree owns 5% or more of the company, or
____ A PERA retiree owns less than 5% of the company, or
____ No percentage of the company is owned by a PERA retiree
3. The Vendor shall comply with the provisions of 24-51-401 C.R.S. The undersigned hereby swears or affirms under penalty of perjury under the laws of the State of Colorado that (check one):
____ The company employs a PERA retiree and is under agreement to perform a service with the state agency. If this is the case, than _________ percentage of the total dollar amount of the contract is attributable to PERA retiree. Or
____ The company does not employ a PERA retiree and is under agreement to perform a service with the state agency
4. The Vendor shall comply with the provisions of 24-51-1101(2). The undersigned hereby swears or affirms under penalty of perjury under the laws of the State of Colorado that (check one):
____ The company is affiliated with and profits from the performance of services by a PERA retiree, or
____ The company is not affiliated with and does not profit from the performance of services by a PERA retiree
CERTIFIED and AGREED to this _____ day of __________________, 202_.
VENDOR:
(Vendor Full Legal Name) (FEIN or Social Security Number)
BY: _____________________________ ____________________
Signature of Authorized Representative Title
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