LIVING_WAGE_CERTIFICATION.pdf
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- Attached to
- FURNISH AND INSTALL TRANSIT SHELTERS
- Solicitation number
- 25/26-5
- Issued by
- Hartford County, Connecticut
About this file
This document is a Living Wage Certification Form from the Town of Manchester, requiring bidders to certify their compliance with the Manchester Living Wage Ordinance (Chapter 212, Sections 212-1 through 212-11). The form mandates that bidders indicate whether they are a "Covered Employer" subject to the ordinance or exempt from its requirements, with a clear warning that failure to complete and return the form may result in bid rejection.
The form provides three potential exemption criteria: employing fewer than 25 eligible employees, having an annual contract value less than $25,000, or being a charitable foundation/nonprofit with federal income tax exemption under Section 501 of the Internal Revenue Code. Bidders must check the appropriate box indicating their status, with the option to either affirm they will pay the required living wage to eligible employees or declare their exemption. The form requires the authorized representative to sign and certify the accuracy of their representations for a 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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