ComplianceStateTaxLaws~67.pdf
PDF 9 KB Posted
- Solicitation number
- BD-27-1069-MILDV-40000-132131
- Issued by
- Berkshire County, Massachusetts
About this file
This is a Certificate of Compliance with State Tax Laws form issued by the Commonwealth of Massachusetts Department of Capital Asset Management (DCAM) for use in state and local contract opportunities within Massachusetts. The document is required for the ITB SPBN262005 contract opportunity involving repair of an HVAC system at Building 197 of Otis Air National Guard Base in Massachusetts. The project scope includes removal of a compromised primary condensing coil from a designated outdoor Daikin HVAC unit and installation of a high-performance replacement unit.
The certificate requires an authorized signatory of the bidding contractor to certify under penalties of perjury that the business entity has filed all required state tax returns, paid all applicable taxes as required by law, and complied with all state laws pertaining to unemployment compensation contributions and payments in lieu of contributions. The contractor must provide the business organization name, principal place of business address, and either a Social Security Number or Federal Identification Number. The completed form must be signed and dated by the authorized representative and includes the contractor's name and title. This certification is mandated under Massachusetts General Law Chapter 62C, Section 49A and Chapter 151A, Section 19A, and serves as a compliance prerequisite for contract award eligibility.
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Text version
Certificate of Compliance with State Tax Laws DCAM Rev. 04/02
CERTIFICATE OF COMPLIANCE WITH STATE TAX LAWS AND
WITH UNEMPLOYMENT COMPENSATION CONTRIBUTION
REQUIREMENTS
Pursuant to M.G.L., Ch. 62C, s. 49A and M.G.L., Ch. 151A, s. 19A, I, ________________________________________________ authorized signatory for
________________________________ whose principal place of business is at
_______________________________________________________ do hereby certify under penalties of perjury that ___________________________________ has filed all state tax returns and paid all taxes as required by law and has complied with all state laws pertaining to contributions to the unemployment compensation fund and to payments in lieu of contributions.
The Business Organization Social Security Number or Federal Identification Number is
Signed under the penalties of perjury the __________ day of ________________
20 ____.
Signature: _______________________________________
Name and Title: ________________________________________
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