Exhibit C - STATUTORY CERTIFICATIONS AND AUTHORIZED SIGNATURE.pdf
PDF 283 KB Posted
- Attached to
- Moving Services
- Solicitation number
- S-P02509-00016339
- Issued by
- Benton County, Oregon
About this file
This is a Statutory Certifications and Authorized Signature form required for bid submission to the Corvallis School District and Wenaha Group for Moving Services related to school consolidations in Oregon. The form establishes the baseline compliance and eligibility requirements that all bidders must meet and certify to in order for their proposals to be considered. Bidders must declare their residency status under Oregon Revised Statute (ORS) 279A.120(1)(b), certify non-discrimination practices in subcontracting, confirm tax compliance, attest to non-collusion in bid pricing, commit to using recycled and recoverable materials to the maximum economically feasible extent, and disclose any conflicts of interest involving agency officers, agents, or employees. The authorized representative of the bidding company must sign and date the form, certifying that all responses are complete, accurate, and not misleading, with acknowledgment that false or fraudulent statements may result in bid disqualification or contract termination.
The form requires bidders to provide their legal company name, authorized signature, printed name and title of the signatory, Federal Tax ID Number (FEIN), and Oregon Secretary of State Corporation Division Active Business Registry Number. These certifications are statutory requirements under Oregon law and serve to ensure bidder eligibility, ethical conduct, and compliance with state procurement regulations. No pricing information, set-asides, incumbent details, or financial terms are addressed in this particular document, as it functions solely as a compliance certification vehicle rather than a substantive bid or contract terms document.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit B - Insurance Example - Service Agreement.pdf | ||
| CSD RFP for Moving Services Addendum 1.pdf | ||
| Exhibit A - Cost Proposal.xlsx | XLSX spreadsheet | |
| CSD RFP for Moving Services 03.2026 FINAL.pdf |
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Text version
STATUTORY CERTIFICATIONS & AUTHORIZED SIGNATURE
1. Bidder Residency Statement
Statutory Reference: ORS 279A.120(1)(b) defines a "Resident Bidder" as one who has paid unemployment taxes or income taxes in Oregon during the 12 calendar months immediately preceding bid submission, has a business address in this state, and has stated in the bid whether they are a resident bidder.
CHECK ONE:
• [ ] Bidder IS a Resident Bidder (as defined in ORS 279A.120).
• [ ] Bidder IS NOT a Resident Bidder.
o If not a resident, please indicate the State of Residence: ________________
2. Certification of Non-Discrimination
Statutory Reference: Pursuant to ORS 279A.110, the Bidder certifies that they have not and will not discriminate against a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a business that a service-disabled veteran owns, or an emerging small business in the awarding of subcontracts.
3. Tax Compliance Certification
Statutory Reference: Pursuant to ORS 305.385, the undersigned hereby certifies, under penalty of perjury, that to the best of their knowledge, the Bidder is not in violation of any tax laws described in
ORS 305.380(4).
4. Non-Collusion Certification
Statutory Reference: Pursuant to ORS 279B.055, the undersigned certifies that the price(s) and amount of this bid have been arrived at independently and without consultation, communication, or agreement with any other bidder or competitor.
5. Recycled Materials & Recovered Resources
Statutory Reference: Pursuant to ORS 279A.125 and ORS 279B.270, the Bidder shall use recycled and recyclable products to the maximum extent economically feasible during the performance of the
Contract if awarded.
6. Conflict of Interest Disclosure
Statutory Reference: Pursuant to ORS Chapter 244, the Bidder certifies that no officer, agent, or employee of the Agency has a pecuniary interest in this bid or has participated in the preparation of this bid on behalf of the Bidder, except as has been previously disclosed in writing.
Authorized Signature
By signature below, the undersigned Authorized Representative on behalf of Bidder certifies to the best of their knowledge and belief that the responses provided on this form are complete, accurate, and not misleading. I acknowledge that any false, deceptive, or fraudulent statements may result in disqualification or termination of any resulting contract.
Legal Name of Compnay: __________________________________________________
Authorized Signature: ____________________________________ Date: ___________________
Printed Name: __________________________________________ Title: ____________________
Federal Tax ID Number (FEIN): ________________________
Oregon Secretary of State Corporation Division Active Business Registry No.:
https://sos.oregon.gov/business/pages/default.aspx https://sos.oregon.gov/business/pages/default.aspx
File details come from the government source that posted it. Updated .