contract frmNewContractAffidavit(4).pdf
PDF 29 KB Posted
- Solicitation number
- BPM030499
- Issued by
- St. Mary's County, Leonardtown Town, Maryland
About this file
The document provided is a Contract Affidavit for a state and local contract opportunity in the state of Maryland. The contract is for Fire, Sprinkler, & Extinguisher Service at a location in Leonardtown, MD, beginning on July 1, 2022, and continuing for a three-year term until June 30, 2025. The contract is for the jurisdictions of St. Mary's County and the Town of Leonardtown.
The affidavit requires the authorized representative of the business to affirm that the business is a domestic or foreign corporation registered in Maryland and in good standing, and that it has paid all applicable taxes and filed all required returns and reports. The affidavit also requires the representative to reaffirm the certifications and acknowledgments made in the original Bid/Proposal Affidavit.
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Text version
COMAR 21.07.01.25
CONTRACT AFFIDAVIT
Exhibit ___________________ Bid Proposal #_________________
A. AUTHORIZED REPRESENTATIVE
I HEREBY AFFIRM THAT:
I am the (title) _____________________________________________________________________________ and the duly authorized representative of (business) _______________________________________________________ and that I possess the legal authority to make this Affidavit on behalf of myself and the business for which I am acting.
B. CERTIFICATION OF CORPORATION REGISTRATION AND TAX PAYMENT
I FURTHER AFFIRM THAT:
1. The business named above is a (domestic_____) (foreign_____) corporation registered in accordance with the Corporations and Associations Article, Annotated Code of Maryland, and that it is in good standing and has filed all of its annual reports, together with filing fees, with the
Maryland State Department of Assessments and T axation, and that the name and address of its resident agent filed with the State Department of Assessments and T axation is:
Name: _______________________________________________________________________
Address: _______________________________________________________________________
2. Except as validly contested, the business has paid, or has arranged for payment of, all taxes due the
State of Maryland and has filed all required returns and reports with the Comptroller of the
Treasury, the State Department of Assessments and Taxation, and the Department of Labor, Licensing, and Regulation, as applicable, and will have paid all withholding taxes due the State of
Maryland prior to final settlement.
C. CERTAIN AFFIRM ATIONS VA LID
I FURTHER AFFIRM THAT:
To the best of my knowledge, information, and belief, each of the affirmations, certifications, or acknowledgments contained in that certain Bid/Proposal Affidavit dated ________ , 20___ , and executed by me for the purpose of obtaining the contract to which this Exhibit is attached remains true and correct in all respects as if made as of the date of this Contract Affidavit and as if fully set forth herein.
I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE
CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE,
INFORMATION, AND BELIEF.
Date: ______________________________ By: ___________________________________________________________________ (Authorized Representative and Affiant)
(Printed or Typed Name)
DGS 360-17 (rev 5/05)
File details come from the government source that posted it. Updated .