Attachment_C_Required_Forms.pdf

ATTACHMENT C – REQUIRED FORMS

The following forms must be completed, signed, and included with all proposal submissions.

Failure to submit any required form will render the proposal non-responsive.

Required Forms Checklist ☐ Certification of Compliance with Commonwealth Tax Laws (M.G.L. c. 62C, §49A)

☐ Non-Collusion Affidavit (M.G.L. c. 30B, §10) – including Notary Acknowledgment

☐ Certificate of Good Faith / Non-Collusion and Tax Compliance

☐ Disclosure Statement for Transactions with Public Agency Concerning Real Property (M.G.L. c. 7C, §38)

☐ Certificate of Authority (for Corporations and LLCs)

CERTIFICATION OF COMPLIANCE WITH COMMONWEALTH TAX LAWS

Pursuant to M.G.L. c. 62C, §49A, I certify under the penalties of perjury that I have filed all state tax returns and paid all state taxes required under law.

Signature: ________________________________

Printed Name: _____________________________

Name of Business: __________________________

Date: _____________________________

NON-COLLUSION AFFIDAVIT

I certify under the penalties of perjury that this proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this affidavit, the word 'person' shall mean any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group of individuals.

Notary Public:

On this ____ day of __________, 20__, before me, the undersigned notary public, personally appeared __________________, proved to me through satisfactory evidence of identification to be the person whose name is signed above.

Notary Signature: _________________________

My Commission Expires: _____________________

CERTIFICATE OF GOOD FAITH / NON-COLLUSION AND TAX COMPLIANCE

The undersigned certifies under the penalties of perjury that:

1. The proposal is made in good faith and without collusion or fraud.

2. The proposer has complied with all laws relating to taxes as required by M.G.L. c. 62C, §49A.

DISCLOSURE STATEMENT FOR TRANSACTIONS WITH PUBLIC AGENCY

CONCERNING REAL PROPERTY

This disclosure statement is required by M.G.L. c. 7C, §38. Every person acquiring real property from a public agency must disclose the names and addresses of all persons who have or will have a direct or indirect beneficial interest in the property.

Property: ____________________________________________ Name of Purchaser/Entity: _______________________________

Names and Addresses of All Beneficial Owners:

1. ____________________________________________

2. ____________________________________________

3. ____________________________________________

CERTIFICATE OF AUTHORITY

I, ________________________, Clerk/Secretary of __________________________ (the “Corporation”), hereby certify that the following vote was adopted at a meeting of the Board of Directors duly called and held on __________ and remains in full force and effect:

VOTED: That ____________________________, who holds the office/title of ________________________, is hereby authorized on behalf of the Corporation to execute contracts, proposals, and other instruments in the name and on behalf of the Corporation.

Clerk/Secretary Signature: _________________________