Attachment J.6 Tax Certification Affidavit.pdf
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- Attached to
- DC Courts Signage and Wayfinding System
- Solicitation number
- DCSC-24-RFP-212
- Issued by
- District of Columbia Government
About this file
This document is a Tax Certification Affidavit required for all bids/offers over $100,000 for contracts with the District of Columbia Courts (the Courts). The affidavit certifies the bidder's compliance with applicable tax law filings and licensing requirements, and their current tax liability status. It authorizes the Courts to verify the information with the appropriate government authorities. The affidavit outlines penalties for making false statements.
The related federal contract opportunity is for Signage and Wayfinding Services for the District of Columbia Courts, solicitation number DCSC-24-RFP-212. The contract will be a hybrid, with a fixed-price component for management and other direct costs, and a cost-reimbursable component for production, procurement, and installation of signage. The contract term is 5 years, with 2 base years and 3 option years. The services required include developing signage policies and procedures, designing, procuring, fabricating, and installing all signage types, and coordinating with other Courts contractors. A pre-proposal briefing will be held on April 17, 2024, and proposals are due by April 15, 2024.
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Text version
ATTACHMENT J.6
TAX CERTIFICATION AFFIDAVIT
For all bids/offers over 100,000.00, the following affidavit is required:
__________________________________, 20 ______.
I hereby certify that:
1. I have complied with the applicable tax law fillings and licensing requirements of the District of
Columbia.
2. The following information is true and correct concerning the payment of my tax liability:
State:_____________________________ Current Not Current
Unemployment Insurance_______________________ Current Not Current
3. If not current, as checked in Item 2, I am in compliance with a payment agreement with the
Department of Finance and Revenue Yes No, and/or the Department of
Employment Services Yes No.
4. My tax numbers are as follows:
D.C. Employer Tax ID No.: _______________________________________________
Unemployment Insurance Account No.:_______________________________________
D-U-N-S No.:____________________________________________________________
The D.C. Courts is hereby authorized to verify the above information with appropriate Government authorities. Penalty of making false statements is a fine of not more than $1,000.00, imprisonment for not more than one (1) year or both, as prescribed in D.C. Code Sec. 22-2514. Penalty for false swearing is a fine of not more than $2,500.00, imprisonment for not more than three (3) years, or both, as prescribed in D.C. Code Sec. 22-2513.
Signature of Person Authorized to Sign Title
This Document
Typed or Printed Name
Name of Organization __________________________________________________________
Notary: Subscribed and sworn before me this __day of ________________, 20 at
___________________________ at ___________________________________
Month and Year City and State
File details come from the government source that posted it. Updated .