LIVING_WAGE_CERTIFICATION.pdf
PDF 227 KB Posted
- Attached to
- SCADA TELEMETRY SYSTEM STUDY AND SURVEY
- Solicitation number
- 24/25-87
- Issued by
- Hartford County, Connecticut
About this file
This document is a Living Wage Certification Form from the Town of Manchester, addressing compliance with the Manchester Living Wage Ordinance (Chapter 212, Sections 212-1 through 212-11). The form requires bidders to declare whether they are a "Covered Employer" subject to the ordinance's requirements or exempt from them. 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 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 organization exempt from federal income taxation under Section 501 of the Internal Revenue Code. Bidders must select either compliance with the living wage requirement or indicate their exemption status by checking the appropriate box. The form requires the authorized representative to sign and certify the accuracy of their representations, including their company name and the specific Bid/RFP number and name.
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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.
Please indicate the reason, if you are not a covered employer, 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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