Suffolk Adams - Curb Stair Repair - Certificate on Non-Collusion.pdf
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- Solicitation number
- BD-26-1107-FREG5-ACCOU-127822
- Issued by
- Massachusetts
About this file
This is a Certificate of Non-Collusion and Tax Compliance Certification for the Suffolk and Adams Courthouses Stair and Curbing Renovations project in Massachusetts. The certificate serves as a required submission document for bidders responding to this state contract opportunity, which involves the removal of 370 linear feet of concrete curbing and its replacement with granite curbing, as well as repair of the first stair at the Suffolk Courthouse. Bidders submitting proposals must execute this certification form, acknowledging under penalties of perjury that their bid is bona fide, fair, and made without collusion or fraud with any other party.
The certificate requires the authorized representative submitting the bid to certify compliance with all Massachusetts General Laws Chapter 62C Section 49A regulations pertaining to taxes, employee and contractor reporting, and child support withholding and remittance obligations. Signatories must provide their signature, printed name, business name, and Social Security Number or Federal Identification Number on the form. The Commonwealth of Massachusetts reserves the right to furnish the submitted tax identification information to the Massachusetts Department of Revenue to verify tax filing and payment compliance. Providers failing to correct any identified non-filing status or tax delinquencies will be ineligible to have contracts issued, renewed, or extended.
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CERTIFICATE OF NON-COLLUSION AND TAX COMPLIANCE CERTIFICATION
The undersigned certifies under penalties of perjury that this bid or proposal is in all respects bona fide, fair and made without collusion or fraud with any other person. As used in this certification, the word "person" shall mean any natural person, joint venture, partnership, corporation, union, committee, club, or other organization, entity, business, group of individuals or legal entity.
Pursuant to M.G.L. c. 62C, §49A, I certify under the penalties of perjury that, to the best of my knowledge and belief, I am in compliance with all laws of the Commonwealth relating to taxes, reporting of employees and contractors, and withholding and remitting child support.
Signature of authorized person submitting bid or proposal Date
Printed name of authorized individual signing above
Name of business
*Social Security Number or Federal Identification Number
*Your social security number and or federal identification number may be furnished to the
Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Providers who fail to correct their non-filing or delinquency will not have a contract or other agreement issued, renewed, or extended.
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