LIVING_WAGE_CERTIFICATION.pdf
PDF 280 KB Posted
- Solicitation number
- 25/26-1
- Issued by
- Hartford County, Connecticut
About this file
The document is a Living Wage Certification Form issued by the Town of Manchester, Connecticut, related to a contract for yard waste and wood grinding services. The form requires bidders to certify whether they are a "Covered Employer" under the Manchester Living Wage Ordinance (Chapter 212, Sections 212-1 through 212-11) and are obligated to pay a living wage to eligible employees during the contract term. Bidders must complete and return this form with their bid/RFP submission, with failure to do so potentially resulting in bid rejection.
The form provides exemption options for bidders who: employ fewer than 25 eligible employees, have an annual contract value less than $25,000, or are charitable foundations/nonprofits exempt from federal income taxation under Section 501 of the Internal Revenue Code. Bidders must check one of two options: either affirming they are a covered employer who will comply with the living wage requirements, or declaring they are not a covered employer and explaining their exemption. The form requires the bidder's authorized representative to sign and certify the accuracy of their representations for the specific bid or RFP.
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Text version
TOWN OF MANCHESTER
LIVING WAGE CERTIFICATION FORM
The Town of Manchester has determined that this contract may be subject to the provisions of the
Manchester Living Wage Ordinance, Chapter 212 of the Manchester Code of Ordinances, Sections 212-1 through 212-11.
Bidders are required to indicate whether they are a Covered Employer as defined by the Manchester
Living Wage Ordinance or are exempt from the requirements by marking the appropriate section below.
*****Failure to complete and return this form may result in the rejection of your Bid/RFP.*****
I/We are a covered employer and shall pay the required living wage to eligible employees and comply with the requirements of the ordinance during the term of the contract.
OR
I/We are not a Covered Employer and therefore not subject to Manchester’s Living Wage
Ordinance for the reason(s) indicated below.
If you are not a covered employer, please indicate the reason by checking the box or boxes that apply directly below.
Bidder employs less than twenty-five (25) eligible employees.
Annual contract value is less than $25,000.
Charitable foundations, charitable trusts or nonprofit agencies or nonprofit corporations, provided that the foundation, trust or nonprofit agency or corporation is exempt from federal income taxation and may accept charitable contributions under Section 501 of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as from time to time amended.
I, __________________________________________ am the Officer, Owner, Authorized Representative of ______________________________________________________________, the company named in the Bid or RFP, and do hereby certify that the representations made above are true and correct for
Bid/RFP Number________________ Bid/RFP Name ___________________________________________
Signature Print Name Date
Please return with your Bid or RFP submission.
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