contract frmNewContractAffidavit(4).pdf
PDF 29 KB Posted
- Attached to
- Snow Removal Service
- Solicitation number
- BPM016621
- Issued by
- Howard County, Elkridge CDP, Maryland
About this file
The document provided is a Contract Affidavit form required for a state and local contract opportunity to provide snow removal services in Howard County, Maryland. The contract is for a 3-year term beginning November 1, 2019 and ending April 30, 2022 at the Ellicott City DC/MSC located at 3451 Courthouse Drive, Ellicott City, Maryland 21043. The affidavit requires the authorized representative of the bidding business to certify the company's registration status, tax payment compliance, and the validity of statements made in the Bid/Proposal Affidavit.
The contract opportunity does not provide details on pricing terms, set asides, incumbents, funding requirements or sources. The affidavit is a standard form required by the State of Maryland for state and local government contracts.
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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 .