PROPOSERS BIDDERS CERTIFICATION_FILLABLE (2).pdf
PDF 65 KB Posted
- Attached to
- Alba Park Flag Poles Design Build
- Solicitation number
- RFQ 2025-001
- Issued by
- Jackson County, Oregon
About this file
This document is a Proposers/Bidders Certification form for the City of Medford, Oregon, designed for potential contractors to complete when submitting a bid or proposal. The form requires contractors to certify their compliance with various local, state, and national legal requirements, including holding appropriate professional registrations, adhering to non-discrimination policies, and agreeing to obtain a City of Medford Business License for the duration of the contract.
Key requirements include certifying residency status under Oregon Revised Statute 279A.120, confirming compliance with Oregon tax laws, and providing proof of completion of a free online Pay Equity Training for businesses. Contractors must also acknowledge receipt of any addenda to the solicitation and verify that the individual signing the document is authorized to fully bind the contractor to the proposed contract's conditions and provisions. The form includes spaces for contact information, signature, and other pertinent details to validate the contractor's bid or proposal.
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Other files
| File | Type | Posted |
|---|---|---|
| 1056.R1 Contractor Tax Compliance Certification Fillable Form.pdf | ||
| RFQ Alba Park Flag Poles.pdf |
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Text version
CITY OF MEDFORD
PROPOSERS/BIDDERS CERTIFICATION
Contractor
Physical Address
City, State, Zip
1. The Contractor certifies that he/she has read and understands all terms and conditions of this solicitation and the sample contract.
2. The Contractor acknowledges that the person that signs this Certification is fully authorized to sign on behalf of the Contractor listed and to fully bind the Contractor to all conditions and provisions thereof.
3. The Contractor certifies that Contractor has complied or will comply with all requirements of local, state and national laws and that no legal requirement has been or will be violated in making or accepting this
RFP/ITB/RFQ.
4. The Contractor holds any required certificates for the State of Oregon designated in the complete document as applicable (Contractors, Architects, Landscape Board, Engineers, etc.).
Applicable Registration #s: ______________________________________________________.
5. The Contractor, pursuant to ORS 279A.120 (1) (check one) is _______ /is not_______ a Resident Bidder. If not, indicate State of Residency:__________________________.
6. The Contractor certifies that it has not discriminated and will not discriminate, in violation of ORS 279A.110, against any minority, women or emerging small business enterprise in obtaining any required subcontract.
7. The Contractor agrees to comply with Oregon tax laws in accordance with ORS 305.385.
8. The Contractor will be required to provide a copy of the certificate showing they completed the free online
Pay Equity Training for businesses prior to award of contract per ORS 2749A.167 link to training:
https://www.oregon.gov/das/Procurement/Pages/PayEquity.aspx
9. The Contractor agrees to obtain/retain a City of Medford Business License for the duration of this contract.
10. The Contractor acknowledges receipt of the following addenda: (List by number and date appearing on addenda.)
Addendum Number Date Addendum Number Date
Respectfully submitted this _________day of __________________, 20___.
Signature: ______________________________________________________
Name: __________________________________________________________ Phone:______________________________ (Print/Type) Title: ____________________________________________________________ Fax:_________________________________
Email Address: ______________________________________________________________________________________________
| PROPOSERSBIDDERS CERTIFICATION: |
| Contractor: |
| Physical Address: |
| as applicable Contractors Architects Landscape Board Engineers etc: |
| The Contractor pursuant to ORS 279A120 1 check one is: |
| Addendum Number 1: |
| Addendum Number 2: |
| Date 1: |
| Date 2: |
| Addendum Number 1_2: |
| Addendum Number 2_2: |
| Date 1_2: |
| Date 2_2: |
| day of: |
| 20: |
| undefined_3: |
| PrintType: |
| Phone: |
| Fax: |
| Check Box1: Off |
| Check Box2: Off |
| Text3: |
File details come from the government source that posted it. Updated .