Tax Compliance Form

This is a Tax Compliance Form issued by the State of Georgia for use in conjunction with state and local contract opportunities, specifically related to a Clayton County asphalt maintenance and seal coating services bid. The form requires suppliers to provide comprehensive tax identification information, including Federal Identification Numbers, Georgia State Taxpayer Identification Numbers, Sales and Use Tax Numbers, and Withholding Tax Numbers. Suppliers must also disclose the type of services to be performed, whether tangible personal property will be sold, and information regarding any affiliated entities. The Clayton County contract opportunity for asphalt maintenance and seal coating services included a non-mandatory pre-bid conference scheduled for March 9, 2023, at 10:00 a.m. EST, with sealed bids due on March 30, 2023. Registration for the virtual pre-bid conference required email submission to centralservicesbids@claytoncountyga.gov. The contract was ultimately awarded to The Tomal Corporation dba Wildcat Striping, Sealing, and Paving, though specific pricing, contract term, and renewal options were not disclosed in the award acknowledgment.

The Tax Compliance Form requires suppliers to designate a person responsible for handling tax issues and emphasizes that submitted information will be forwarded to the Georgia Department of Revenue for verification of eligibility. Critically, the form warns that suppliers deemed "prohibited sources" under O.C.G.A. 50-5-82 are ineligible for contract award and that missing, incomplete, or erroneous data may delay or prohibit verification of eligibility. Suppliers are strongly encouraged to verify their tax status and resolve any outstanding tax liabilities or missing tax returns prior to submission. Completed forms must be submitted via email to the Georgia Department of Revenue at tsd-state-contractors@dor.ga.gov for processing in accordance with the Georgia Procurement Manual.