FY16 CONTRACTUAL INSTRUCTIONS SAFETY.docx

CONTRACT INSTRUCTIONS

There are several contractual documents that you must complete and sign (ALL signatures and dates must be original and in ink – NO STAMPS). Whether contracting through a corporation, other organization, or as an individual - please make sure to be consistent with the listing of information (as some information is required on multiple forms). There are also instructions for each form.

Please Note: Some of our forms have been revised. If you need assistance please call the Contracts & Procurements unit at 617-626-5913.

STANDARD CONTRACT FORM(SCF)

Please complete the top-left and bottom-left sections of this form. Please make sure you use the complete legal name and the legal address of the entity applying for the grant on this and all contractual documents. If you are unsure of your Vendor Code and Address ID, you may leave them blank. Please make sure that the individual signing this form is an authorized signatory; an authorized signatory must be identified on the Contractor Authorized Signature Verification Form and the Contractor Authorized Signatory Listing Form.

COMMONWEALTH TERMS AND CONDITIONS (T&C)

Please read the first page and a half of the Commonwealth’s Terms and Conditions to which you will be bound. Please complete the bottom half of page two of this form, please make sure that you use the complete legal name and the legal address of the entity applying for the grant on this and all contractual documents. Also please make sure that the individual signing this form is an authorized signatory; an authorized signatory must be identified on the Contractor Authorized Signature Verification Form and the Contractor Authorized Signatory Listing Form.

REQUEST FOR TAXPAYER IDENTIFICATION NUMBER AND CERTIFICATION (SUBSTITUTE W-9)

Please complete the attached Request for Taxpayer Identification Number and Certification (Substitute W-9). Please make sure that you use the complete legal name and the legal address of the entity applying for this grant on this and all contractual documents. If you are already registered as a vendor with the Commonwealth of Massachusetts Office of the State Comptroller, and want to make an address change, you will need to also include a letter requesting the change. The letter should specify your request and include your Vendor Code and new address; if you are changing your legal and/or remittance address (as opposed to simply requesting an additional remittance address), you should also specify the Address Code and the address that is being replaced.

If any of the information on this form changes after submission (i.e., name, address, or tax identification number), please call the Contracts & Procurements unit (617-626-5913) to obtain assistance in updating this information.

CONTRACTOR AUTHORIZED SIGNATORY LISTING (CASL)

Please complete the Contractor Authorized Signatory Listing form; please make sure that the individual(s) who are authorized to sign the contractual documents for this grant name(s) and title(s) are listed in the middle of the page. The individual who certifies the authorization must hold one of the following titles; President, CEO, CFO, Corporate Clerk, or Legal Counsel.

This form is used to verify that the person signing the contractual documents is specifically authorized to execute and bind the organization into a contractual relationship with the Commonwealth of Massachusetts, Executive Office of Labor and Workforce Development, Department of Industrial Accidents, Office of Safety. The information provide on this form will be confirmed by the Executive Office of Labor and Workforce Development by comparing the names and titles provided on the form against what is on record with the Commonwealth of Massachusetts Secretary of States Corporate Division.

CONTRACTOR AUTHORIZED SIGNATURE VERIFICATION FORM (CASV)

Please complete either the Contractor Authorized Signature Verification Form for Corporations Only or the Contractor Authorized Signature Verification Form for Individuals, Partnerships, LLC or other Entities only, whichever is applicable. This form should be completed for every authorized signatory as listed on the CASL. This form is used to verify that the person signing the contractual documents is specifically authorized to execute and bind the organization into a contractual relationship with the Commonwealth of Massachusetts, Executive Office of Labor and Workforce Development, Department of Industrial Accidents, Office of Safety. The information provide on this form will be confirmed by The Executive Office of Labor and Workforce Development by comparing the names and titles provided on the form against what is on record with the Commonwealth of Massachusetts Secretary of States Corporate Division.

Note: The individual signing the contractual documents must also have been certified as an authorized signatory on the Contractor Authorized Signatory Listing Form, referred to above.

Please read the instructions carefully. Requirements differ for Corporations as well as for Individuals, Partnerships and Other Entities.

SIGNATURE

The Signatory’s signature is verified through the Signatory’s completion of the CASV form and:

1. Providing an official sample of his/her signature (copy of a driver’s license, passport, business ID or other official form or identification containing the authorized Signatory’s signature); or

2. Signing the CASV before a Notary Public who also signs the CASV; or

3. Signing before the Corporate Secretary who also signs the CASV (Corporations only - See Option 1 on the “For Corporations Only” CASV form).

Legal Authority The legal authority of the Signatory to bind the vendor to a contractual agreement is verified through the CASV form. The following is a list of acceptable methods of verification for different types of business entities.

Corporations:

1. Completion of Option 1 on the “For Corporations Only” CASV requires signing the CASV before the Corporate Secretary who verifies both the signature and authority of the Signatory to execute Contracts on behalf of the corporation. (If the Corporate Secretary is also the Signatory, Option 2 on the CASV must be used because the Corporate Secretary cannot self-certify.)

2. Completion of Option 2 on the “For Corporations Only” CASV requires the submission of:

a. A signed Board of Directors’ Vote / Resolution / Minutes or equivalent stating that the Signatory, by name or title, has authority to sign Contracts on behalf of the corporation; or

b. A copy of the corporation’s Bylaws stating that the Signatory, by name or title, has authority to sign Contracts on behalf of the corporation.

Individuals/Sole Proprietor:

1. The owner has signature authority. If someone other than the owner is the Signatory, the owner must provide written authorization stating that the Signatory has authority to sign Contracts on the owner’s behalf. The Signatory’s signature is verified through the Signatory’s completion of the CASV form and: providing an official sample of his/her signature (copy of a driver’s license, passport, business ID or other official form or identification containing the authorized Signatory’s signature); or Signing the CASV before a Notary Public who also signs the CASV.

Partnerships:

1. Each Partner has signature authority.

2. If someone other than a Partner is the Signatory, a Partner must provide written authorization stating that the Signatory has authority to sign Contracts on behalf of the Partnership.

LLC’s:

1. Each Manager/Member has signature authority.

2. If someone other than a Manager/Member is the signatory, a Manager/Member must provide written authorization stating that the Signatory has authority to sign Contracts on behalf of the LLC.

Banks:

The same options for a Corporation apply, however, but banks must also provide a copy of the Board of Directors’ minutes, showing the election/appointment of the current Corporate Secretary.

ELECTRONIC FUNDS TRANSFER SIGN UP FORM (EFT)

Please complete this form in its entirety, sign, date, and return with the Contract.

The “Vendor” will be considered to be the same as the “Contractor”, and the pertinent information (Tax Identification Number, Name, Address, etc.) should be the same as on other contract forms.

CERTIFICATE OF GOOD STANDING (CGS)

You will need to obtain this form from the Department of Revenue, not from the Secretary of State’s Office. You may do this via the DOR website (https://wfb.dor.state.ma.us/webfile/Certificate/Public/WebForms/Welcome.aspx).

For questions, call 617-887-MDOR or 800-392-6089 (toll-free in Massachusetts).

COMMBUYS REGISTRATION

While you may previously have been registered as a seller in Comm-PASS, no vendor registration was transferred to COMMBUYS, so you must now register as a seller in COMMBUYS. To assist you in the registration process, The Operational Services Division (OSD) has provided a series of COMMBUYS job aids and on-line learning videos for use as you transition to COMMBUYS.

COMMBUYS registration is easy! It takes just two simple steps:

DO’s & DON’T’s

DO

Do read the instructions

Do use the proper legal name of the company throughout the documents. (List the dba where indicated.)*

Do use the legal address on all documents. (A remittance address can be included on the W-9.)*

Do print and sign the Signatory’s name consistently throughout the documents. (If the Signatory signs with her/his middle name on one form, s/he should continue to do so on all the forms.)

Do use only one FEIN number on the Contract documents.

Do obtain the Certificate of Good Standing from the Department of Revenue, not from the Secretary of State’s Office.)

Do submit a current Certificate of Good Standing. (current means the CGS must have an issued date that is within 6 months from the contract signature date.)

Do ensure that your Unemployment Insurance, Universal Health Insurance and Fair Share Contribution taxes are up to date and that your Workers Compensation Policy is current. (Non-compliance will cause delays in the process.)

Do ensure that your current Board of Directors is listed with the Secretary of State’s Office. *

Do list the Signatory on the Contractor Authorized Signatory Listing Form. (Include the Signatory’s name and title on the listing as an Authorized Signatory.)

Do use the Massachusetts Substitute W-9 Form, not the Form W-9 from the Department of Treasury Internal Revenue Service.

· We verify legal name, legal address and incumbency of officers / directors via the Secretary of State website (http://www.sec.state.ma.us/)

DON’T

Don’t start services prior to the execution of your Contract. (Payment will not be made for services that are not covered)

Don’t enter the start and end dates on the Contract. (The Agency enters the authorized dates.)

Don’t use white out or correction tape. It invalidates the form.

Don’t submit a blank Electronic Funds Transfer (EFT) form with the information attached. (The form requires contact information and a signature)

Don’t substitute forms in the Contract Package. (The forms are continuously updated; alternate/outdated forms are invalid)

Don’t change the company / organization name/address/bank account without notifying the Department Contract Manager. (It will delay Contract execution and / or payments)

Don’t change/add/delete language to the forms. (Changes will invalidate the document)