ATTACHMENT H - CERTIFICATION OF FINANCIAL CONDITION.pdf
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- Solicitation number
- 163-163-10222026TB
- Issued by
- Mecklenburg County, Cleveland Town, North Carolina
About this file
This is a Certification of Financial Condition form from North Carolina, required for the RFI #163-10222026TB solicitation issued by Charlotte-Mecklenburg Schools (CMS) for Financial Consulting Services. The form serves as a vendor attestation document to be completed and submitted as part of the proposal process. CMS is seeking transitional support to backfill both the Chief Financial Officer (CFO) and Assistant Financial Officer of Budget (AFO of Budget) positions, with services required to maintain financial routines, support staff, protect the budget, and preserve fiscal integrity within the school district.
The certification requires vendors to validate their financial soundness and compliance status by confirming, through checked boxes, statements regarding sound financial condition with unqualified audit opinions, absence of outstanding liabilities to government entities, current tax payment status, absence of litigation or noncompliance findings, and authorization to represent the vendor. Vendors must provide the date of their latest audit (or explain if none exists within the past 18 months) and obtain signatures from an authorized representative. The form explicitly states this serves as a continuing certification, requiring vendors to notify the Contract Lead within 30 days of any material changes to the representations made. Failure to check applicable boxes or provide explanations for unchecked items may result in the vendor submission being deemed non-responsive and rejected in its entirety.
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Text version
North Carolina Certification of Financial Condition Version Date: 09/2021
Page | 1
ATTACHMENT G: CERTIFICATION OF FINANCIAL CONDITION
Solicitation #: __________________________
Vendor Name: __________________________
The undersigned hereby certifies that: [check all applicable boxes]
☐ The Vendor is in sound financial condition and, if applicable, has received an unqualified audit opinion for the latest audit of its financial statements.
Date of latest audit: ____________________ (If no audit within past 18 months, explain reason below.)
☐ The Vendor has no outstanding liabilities, including tax and judgment liens, to the Internal Revenue Service or any other government entity.
☐ The Vendor is current in all amounts due for payments of federal and state taxes and required employment-related contributions and withholdings.
☐ The Vendor is not the subject of any current litigation or findings of noncompliance under federal or state law.
☐ The Vendor has not been the subject of any past or current litigation, findings in any past litigation, or findings of noncompliance under federal or state law that may impact in any way its ability to fulfill the requirements of this Contract.
☐ He or she is authorized to make the foregoing statements on behalf of the Vendor.
Note: This shall constitute a continuing certification and Vendor shall notify the Contract Lead within 30 days of any material change to any of the representations made herein.
If any one or more of the foregoing boxes is NOT checked, Vendor shall explain the reason(s) in the space below. Failure to include an explanation may result in Vendor being deemed non-responsive and its submission rejected in its entirety.
Signature Date
Printed Name Title
[This Certification must be signed by an individual authorized to speak for the Vendor]
ATTACHMENT G: CERTIFICATION OF FINANCIAL CONDITION
| Solicitation: |
| Vendor Name: |
| The Vendor is in sound financial condition and if applicable has received an unqualified audit: Off |
| The Vendor has no outstanding liabilities including tax and judgment liens to the Internal Revenue: Off |
| The Vendor is current in all amounts due for payments of federal and state taxes and required: Off |
| The Vendor is not the subject of any current litigation or findings of noncompliance under federal or: Off |
| The Vendor has not been the subject of any past or current litigation findings in any past litigation: Off |
| He or she is authorized to make the foregoing statements on behalf of the Vendor: Off |
| If no audit within past 18 months explain reason: |
| 1: |
| Date: |
| Printed Name: |
| Title: |
File details come from the government source that posted it. Updated .