Exhibit A EOU Proposal unsigned (3)~1.pdf
PDF 124 KB Posted
- Solicitation number
- S-580100-00012518
- Issued by
- Umatilla County, Oregon
About this file
This is Exhibit A, a Bidder/Proposer Tax Laws and Non-Discrimination Certification form that appears to be from an Oregon state contracting opportunity. The document requires bidders to certify their business designation type, MWESB certification status, and compliance with Oregon tax laws. The form includes space for basic company information including signature, name, title, firm details, address, and contact information.
The form contains three main sections: Business Designation (with options for corporation, partnership, sole proprietorship, governmental/non-profit, and various partnership/LLC structures), MWESB Certification (allowing firms to indicate certification as ESB, MBE, WBE, SDV, or DBE/ACDBE for statistical purposes), and Certificate of Compliance with Tax Laws. The tax compliance section requires certification under penalty of perjury that either the individual or the contractor they represent is not in violation of Oregon tax laws, which are specifically defined in the document as including various state taxes under ORS chapters and programs.
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Text version
EXHIBIT A
BIDDER/PROPOSER TAX LAWS AND NON-
DISCRIMINATION CERTIFICATION
I, the undersigned, have read all of the terms and conditions of this Request for Bid, and I understand that if awarded the contract, I and the firm represented herein shall be bound by its terms and conditions and representations made in this response. I certify that Proposer has not discriminated against minority, women or emerging small business enterprises in obtaining any required subcontracts.
Business Designation (check one):
□ Corporation ☐ Partnership
□ Sole Proprietorship ☐ Governmental/Non-Profit
□ Limited Partnership ☐ Limited Liability Partnership
□ Limited Liability Company
MWESB Certification For statistical purposes only, please indicate if your firm is certified in Oregon as one of the following:
□ Emerging Small Business (ESB)
□ Minority-owned Business Enterprise (MBE)
□ Women-owned Business Enterprise (WBE)
□ Service-Disabled Veteran-owned Small Business (SDV)
□ Disadvantaged Business Enterprise (DBE or ACDBE)
Certificate of Compliance with Tax Laws I, the undersigned, (check one)
□ hereby certify under penalty of perjury that I am not in violation of any Oregon Tax laws,
□ hereby certify under penalty of perjury that I am authorized to act on behalf of Contractor and, to the best of my knowledge, Contractor is not in violation of any Oregon tax laws.
For purposes of this certification, “Oregon Tax Laws” means a state tax imposed by ORS 320.005 to 320.150 and 403.200 to 403.250, ORS Chapters 118, 314, 316, 317, 318, 321 and 323; the elderly rental assistance program under ORS 310.630 to 310.706; and local taxes administered by the Oregon Department of Revenue under
ORS 305.620
Signature: Date:
Name: Title:
Firm:
Address:
City/State/Zip: Phone: ( )
Email: Fax:
File details come from the government source that posted it. Updated .