contractor-authorized-signatory-listing-sole-proprietors~49.pdf
PDF 195 KB Posted
- Solicitation number
- BD-27-1084-POLAI-AW1-134935
- Issued by
- Massachusetts
About this file
This is a Contractor Authorized Signatory Form jointly issued by the Commonwealth of Massachusetts Office of the Comptroller and the Operational Services Division for use by state departments in establishing authorized contract signatories. The form is designed for individuals, sole proprietors, or single member LLCs to provide notarized signatures of authorized representatives who can execute contracts and legally binding documents on behalf of contractors. The form requires the contractor's legal name, vendor/customer code if available, the authorized signatory's full legal name and title, and a notarized signature in ink. The notary must certify through satisfactory evidence of identification that the signatory is the person whose name appears on the document and that they signed the form for its stated purpose. A completed copy of this form must be attached to the record copy of a contract filed with the appropriate state department.
This form relates to the Massachusetts State Police Air Wing Unit's request for vendors to provide commodities and services in support of the Air Wing Unit operations under the SP27-Air Wing-U02 Aircraft commodities and services contract opportunity. The Commonwealth reserves the right to publish the names and titles of authorized signatories but requests that contractors not attach any personally identifiable information such as social security numbers, bank account numbers, driver's licenses, or home addresses to protect privacy and prevent unnecessary public record disclosures. The form serves as the standard authorization document across Commonwealth departments unless superseded by department-specific regulations or policies.
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| SDP Form_Goods and Services~40.xlsx | XLSX spreadsheet | |
| Evaluation Criteria_AIR_Final.docx | DOCX document | |
| Bid Response Sheet~13.docx | DOCX document | |
| Standard Contract Form_Instructions~3.pdf | ||
| Customer Reference Form for bidders~81.doc | DOC document | |
| Terms and Conditions~79.pdf | ||
| RFR_SP27-Air Wing-U02_FINAL~1.pdf | ||
| eppform~79.doc | DOC document | |
| Prompt Pay Discount Form~76.doc | DOC document | |
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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 .