Final_Tax_Certification_Affidavit-NEW_(1)_(1).pdf

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Attached to
Design and Permit Ready Sprinkler Systems Services
Solicitation number
25-S-051
Issued by
District of Columbia

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This is a Tax Certification Affidavit form issued by the Government of the District of Columbia, Office of the Chief Financial Officer, Office of Tax and Revenue, for use in connection with the Design and Permit Ready Sprinkler Systems Services contract opportunity at the DC Armory solicited by the Washington Convention and Sports Authority t/a Events DC. The affidavit is required to be completed only by entities registered to conduct business in the District of Columbia and serves as a prerequisite for contract eligibility. By signing this form, the authorized agent certifies compliance with all applicable District of Columbia tax filing and payment requirements and authorizes the Office of Tax and Revenue to release tax information to the contracting District agency for the sole purpose of verifying tax compliance. The authorization remains valid for one year from the date of execution.

The affidavit requires completion of multiple fields including the organization name, business address, phone number, authorized agent information, principal officer details, Federal Identification Number, Unemployment Insurance Account Number, Square and Lot Information, and contract number. Submission of this form is mandatory for bidders seeking to contract with the District of Columbia, as it establishes tax compliance status necessary for contract award eligibility. False statements on the affidavit carry significant penalties, including fines up to $5,000 and imprisonment for up to 180 days, pursuant to D.C. Official Code 47-4106.

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GOVERNMENT OF THE DISTRICT OF COLUMBIA

Office of the Chief Financial Officer Office of Tax and Revenue

Authorized Agent Name of Organization/Entity Business Address (include zip code) Business Phone Number

I hereby authorize the District of Columbia, Office of the Chief Financial Officer, Office of Tax and Revenue to release my tax information to an authorized representative of the District of Columbia agency with which I am seeking to enter into a contractual relationship. I understand that the information released will be limited to whether or not I am in compliance with the District of Columbia tax laws and regulations solely for the purpose of determining my eligibility to enter into a contractual relationship with a District of Columbia agency. I further authorize that this consent be valid for one year from the date of this authorization.

I hereby certify that I am in compliance with the applicable tax filing and payment requirements of the District of Columbia. The Office of Tax and Revenue is hereby authorized to verify the above information with the appropriate government authorities.

TAX CERTIFICATION AFFIDAVIT

Date

Office of Tax and Revenue, PO Box 37559, Washington, DC 20013

THIS AFFIDAVIT IS TO BE COMPLETED ONLY BY THOSE WHO ARE REGISTERED TO CONDUCT BUSINESS IN

THE DISTRICT OF COLUMBIA.

Authorized Agent Principal Officer Name and Title Square and Lot Information Federal Identification Number Contract Number Unemployment Insurance Account No.

Signature of Authorizing Agent Title

The penalty for making false statement is a fine not to exceed $5,000.00, imprisonment for not more than 180 days, or both, as prescribed by D.C. Official Code §47-4106.

GOVERNMENT OF THE DISTRICT OF COLUMBIA

Office of the Chief Financial Officer Office of Tax and Revenue

I hereby authorize the District of Columbia, Office of the Chief Financial Officer, Office of Tax and Revenue to release my tax information to an authorized representative of the District of Columbia agency with which I am seeking to enter into a contractual relationship. I understand that the information released will be limited to whether or not I am in compliance with the District of Columbia tax laws and regulations solely for the purpose of determining my eligibility to enter into a contractual relationship with a District of Columbia agency. I further authorize that this consent be valid for one year from the date of this authorization.

I hereby certify that I am in compliance with the applicable tax filing and payment requirements of the District of Columbia. The Office of Tax and Revenue is hereby authorized to verify the above information with the appropriate government authorities.

TAX CERTIFICATION AFFIDAVIT

Office of Tax and Revenue, PO Box 37559, Washington, DC 20013 THIS AFFIDAVIT IS TO BE COMPLETED ONLY BY THOSE WHO ARE REGISTERED TO CONDUCT BUSINESS IN THE DISTRICT OF COLUMBIA.

The penalty for making false statement is a fine not to exceed $5,000.00, imprisonment for not more than 180 days, or both, as prescribed by D.C. Official Code §47-4106.

8.2.1.4029.1.523496.503679

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File details come from the government source that posted it. Updated .