LIVING_WAGE_CERTIFICATION.pdf

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Attached to
CONCRETE REPAIRS AT HOCKANUM RIVER WATER POLLUTION CONTROL FACILITY
Solicitation number
25/26-41
Issued by
Hartford County, Connecticut

About this file

Written by GovTribe AI ·

This is a Living Wage Certification Form issued by the Town of Manchester, Connecticut, as a required submission document for the concrete repairs project at the Hockanum River Water Pollution Control Facility. Bidders must complete and return the certification form with their proposal submission by the deadline of March 19, 2026 at 11:00 a.m. via the Town of Manchester Procurement Portal. A mandatory pre-bid meeting is scheduled for March 12, 2026 at 10:00 a.m., with a question submission deadline of March 16, 2026 at 4:00 p.m. The form requires bidders to declare their status as either a covered employer subject to the Manchester Living Wage Ordinance or to claim an exemption based on specific criteria. Failure to complete and return this certification form may result in rejection of the bid.

The Town of Manchester Living Wage Ordinance (Chapter 212 of the Manchester Code of Ordinances) applies to contracts exceeding $25,000 annually. Covered employers with 25 or more eligible employees must pay a living wage of $17.78 per hour for employees with comprehensive health benefits or $26.07 per hour for those without such benefits. Bidders may claim exemption if they employ fewer than 25 eligible employees, if the annual contract value is less than $25,000, or if they operate as a nonprofit organization, charitable foundation, or charitable trust exempt from federal income taxation under Section 501 of the Internal Revenue Code. The certification form requires an authorized company officer or representative to sign and date the declaration under penalty of perjury, certifying the accuracy of the representations made regarding covered employer status or applicable exemptions.

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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.

C h e ck a ny t h at a pp ly

S ig n

D at e h e ck

O nl y O ne om pl e te t h is

S e ct io n

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