LIVING_WAGE_CERTIFICATION.pdf

PDF 280 KB Posted

Attached to
WATER TREATMENT SERVICES
Solicitation number
25/26-33
Issued by
Hartford County, Connecticut

About this file

This is a Living Wage Certification Form issued by the Town of Manchester, Connecticut, in connection with a Water Treatment Services contract opportunity. The form requires all bidders to certify their status regarding compliance with the Manchester Living Wage Ordinance (Chapter 212 of the Manchester Code of Ordinances, Sections 212-1 through 212-11). Bidders must indicate whether they are covered employers subject to the ordinance's living wage requirements or whether they qualify for an exemption. Completion and return of this certification form with the bid or RFP submission is mandatory, and failure to do so may result in bid rejection.

Covered employers are required to pay the mandated living wage to eligible employees and maintain full compliance with the ordinance throughout the contract term. Bidders may claim exemption from the ordinance if they employ fewer than twenty-five eligible employees, the annual contract value is less than $25,000, or if they are charitable foundations, trusts, or nonprofit organizations exempt from federal income taxation under Section 501 of the Internal Revenue Code. The form requires an authorized officer, owner, or representative to sign and certify under penalty that all representations are true and correct, including the specific bid or 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.

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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