ESBD_File_336428_Attachment E - Tax Exemption Certificate.pdf
PDF 22 KB Posted
- Attached to
- ASU Mall Lighting
- Solicitation number
- 22-002CS
- Issued by
- Tom Green County, San Angelo City, Texas
About this file
The document is a Texas Sales and Use Tax Exemption Certification form. It provides information about a state and local contract opportunity in Texas related to the ASU Mall Lighting project. The project scope includes removing existing concrete light pole bases, poles and fixtures, and providing and installing new light poles, light pole bases and lights, new light pole mounted receptacles, lighting control systems, conduit pathways for security systems, a new electrical panel, and all required conduit, wiring, trenching, backfill, and directional boring. The project is located in Tom Green County, Texas.
The document does not provide details on pricing terms, set asides, incumbents, funding requirements and sources, or other salient information about the contract opportunity.
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Text version
01-339 (Back)
(Rev.7-10/7)
Texas Sales and Use Tax Exemption Certification This certificate does not require a number to be valid.
Name of purchaser, firm or agency
Address (Street & number, P.O. Box or Route number) Phone (Area code and number)
City, State, ZIP code
I, the purchaser named above, claim an exemption from payment of sales and use taxes (for the purchase of taxable items described below or on the attached order or invoice) from:
Seller:
Street address: City, State, ZIP code:
Description of items to be purchased or on the attached order or invoice:
I understand that I will be liable for payment of all state and local sales or use taxes which may become due for failure to comply with the provisions of the Tax Code and/or all applicable law.
I understand that it is a criminal offense to give an exemption certificate to the seller for taxable items that I know, at the time of purchase, will be used in a manner other than that expressed in this certificate, and depending on the amount of tax evaded, the offense may range from a Class C misdemeanor to a felony of the second degree.
Purchaser claims this exemption for the following reason:
Purchaser Title Date
NOTE: This certificate cannot be issued for the purchase, lease, or rental of a motor vehicle.
THIS CERTIFICATE DOES NOT REQUIRE A NUMBER TO BE VALID.
Sales and Use Tax "Exemption Numbers" or "Tax Exempt" Numbers do not exist.
This certificate should be furnished to the supplier. Do not send the completed certificate to the Comptroller of Public Accounts.
| Exemption purchaser: |
| Exemption purchaser street: |
| Exemption purchaser phone: |
| Exemption purchaser city: |
| Exempt item description lines: ______________________________________________________________________________________________ |
Exemption reason lines: ______________________________________________________________________________________________
| Exempt seller: |
| Exempt seller street: |
| Exempt seller city: |
| Exempt item description: |
| Exemption reason: |
| Exempt purchaser title: |
| Exempt purchaser sig date: |
| clear2: |
| SaveAs1: |
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