Certification with Regard to Financial Condition~5.docx

DOCX document 14 KB Posted

Attached to
19CBBORIMLICENSERFR: RFR for the Physician Online Initial Licensing Application
Solicitation number
BD-19-1039-EHS01-EHS01-39914
Issued by
Middlesex County, Massachusetts

About this file

The document provided is a Certification with Regard to Financial Condition for a bidder responding to a Request for Response (RFR) issued by the Executive Office of Health and Human Services (EOHHS) on behalf of the Commonwealth of Massachusetts Board of Registration in Medicine (BORIM). The RFR is for the procurement of services to develop, implement, maintain, and support an Online Initial Licensing Application integrated with BORIM's existing applications, as well as to provide Managed Support Services for BORIM's Applications Portfolio.

The certification requires the bidder to affirm the soundness of its financial condition, the absence of outstanding liabilities to government agencies, and the absence of any current or past litigation or findings of non-compliance under federal or state law. The contract opportunity is for the state of Massachusetts, and the certification must be signed by an authorized representative of the bidder.

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Text version

Certification with Regard to Financial Condition

Name of Bidder:

Certification:

A check in the box to the right of each item indicates an affirmative response to the certification.

The undersigned certifies that the Bidder is in sound financial condition, that is has sufficient financial reserves to perform the requirements of this RFR and has received an unqualified audit opinion for the latest audit of its financial statements. Specify the date of the last audit __________________.

The undersigned certifies that the Bidder has no outstanding liabilities to the Internal Revenue Service or other government agencies.

The undersigned certifies that the Bidder is not the subject of any current litigation or findings of non-compliance under federal or state law.

The undersigned certifies that the Bidder has not been the subject of any past litigation or findings of non-compliance under federal or state law.

If one or more of the above boxes are not checked, please explain in the space provided below or attach a clearly labeled separate sheet.

Signature

Printed Name of Signatory

Title

Date

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