contractor-authorized-signatory-listing-for-sole-proprietors~1.pdf
PDF 195 KB Posted
- Solicitation number
- BD-26-1080-OSD01-OSD10-130135
- Issued by
- Massachusetts
About this file
This is a Contractor Authorized Signatory Form jointly issued by the Commonwealth of Massachusetts Office of the Comptroller (CTR) and the Operational Services Division (OSD) for use by all Commonwealth Departments unless otherwise prescribed by regulation or policy. The form is required for any contractor, sole-proprietor, or individual who will sign contracts and other legally binding documents on behalf of the contractor in connection with the related OSD Print Mail Supplies, Equipment and Service contract opportunity. The authorized signatory must provide a notarized signature that matches their Form W-9 tax classification, along with their printed legal name and title, and the notary public must provide their printed name, signature, date, and commission expiration date. A copy of the completed and notarized form must be attached to the record copy of the contract filed with the department.
The form explicitly instructs contractors not to attach documentation containing personally identifiable information such as bank account numbers, social security numbers, driver's licenses, home addresses, or social security cards, as the Commonwealth reserves the right to publish the names and titles of authorized signatories as part of the public record. The signature must be executed in ink on paper in the presence of a notary public, and the notary must affix their official seal or stamp to the document. The form accommodates multiple authorized signatories, with space provided for duplicate signature blocks.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| form_w-9~4.pdf | ||
| standard-contract-form instructions~4.pdf | ||
| Commonwealth terms and conditions~7.pdf | ||
| Bidder Response Form CPMSPRINT.docx | DOCX document | |
| Attachment 3 Category 3 Response Sheet.xlsx | XLSX spreadsheet | |
| Commonwealth Terms and Conditions for Information Technology 070125.pdf | ||
| electronic-funds-transfer-authorization dec 2023~5.pdf | ||
| form_prompt-pay-discount~4.pdf | ||
| Attachment 1 Category 1 Response Sheet.xlsx | XLSX spreadsheet | |
| form_standard-contract~1.pdf | ||
| RFR OSDPRINTMAIL Final 061026.docx | DOCX document | |
| contractor-authorized-signatory-listing-for-contractors~7.pdf | ||
| Attachment 2 Category 2 Response Sheet.xlsx | XLSX spreadsheet | |
| Attachment 4 Category 4 Response Sheet.xlsx | XLSX spreadsheet |
Show all 14
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Commonwealth of Massachusetts
CONTRACTOR AUTHORIZED SIGNATORY FORM
This form is jointly issued and published by the Office of the Comptroller (CTR) and the Operational Services Division (OSD) as the default form for all Commonwealth Departments when another form is not prescribed by regulation or policy.
Notarized Signature for Individual, Sole-Proprietor or Single Member LLC (must match Form W-9 tax classification)
Contractor Legal Name Contractor Vendor/Customer Code (if available, not the Taxpayer Identification Number)
INSTRUCTIONS: Any Contractor, sole-proprietor, or an individual, must provide a notarized signature of the authorized person who can sign contracts and other legally binding documents related to the contract on the Contractor’s behalf.
For privacy purposes DO NOT ATTACH any documentation containing personal information, such as bank account numbers, social security numbers, driver’s licenses, home addresses, social security cards or any other personally identifiable information that you do not want released as part of a public record. The Commonwealth reserves the right to publish the names and titles of authorized signatories of contractors.
Signature (ink on paper) Contractor Signature as it will appear on contract or other documents (Complete only in presence of notary)
Print Signatory’s full legal name Title
Certificate of Acknowledgement of Notary Public Before me, the undersigned notary public, the above named individual proved to me through satisfactory evidence of identification, to be the person whose name is signed above and acknowledged to me that (he)/(she) signed for its stated purpose.
Print Notary Name Notary Signature (ink on paper)
Date My commission expires on
AFFIX NOTARY SEAL/STAMP
A copy of this document must be attached to the “record copy” of a contract filed with the department.
| Notarized Signature for Individual, Sole-Proprietor or Single Member LLC |
| (must match Form W-9 tax classification) |
| Contractor Legal Name: |
| Print Signatorys full legal name: |
| Title: |
| Print Notary Name: |
| Date: |
| My commission expires on: |
| Contractor Vendor/Customer Code: |
File details come from the government source that posted it. Updated .