Tax Compliance Form.doc
DOC document 1 MB Posted
- Attached to
- E-Rate Wireless
- Solicitation number
- PE-55267-NONST-2026-000000035
- Issued by
- Jefferson County, Georgia
About this file
This is a Tax Compliance Form issued by the State of Georgia for suppliers bidding on state and local contracts, specifically related to an E-Rate Wireless equipment procurement by Jones County Schools System (JCSS). The form requires suppliers to submit comprehensive tax and business registration information, including company name, physical address, Federal Identification Number (FEI), state taxpayer identification numbers, and sales and use tax registration details. Suppliers must also disclose whether they have been previously registered in Georgia, provide information on any affiliate entities, and identify the person responsible for handling the supplier's tax issues. The JCSS procurement involves a one-for-one replacement of wireless access points, with the winning vendor responsible for uninstalling current equipment, installing new access points, and transporting removed equipment to the Technology office. Installation must occur when students are not present, and bidders must submit a detailed project plan including hardware lead times, installation timelines, assigned staff, and documentation of prior similar projects, particularly those completed for K-12 entities and Jones County Schools. Pricing will be separated by E-Rate eligible and ineligible locations.
The state entity submitting the Tax Compliance Form to the Georgia Department of Revenue will use the supplier information to verify whether the bidder qualifies as a "prohibited source" under O.C.G.A. 50-5-82 or has any outstanding tax issues that would disqualify them from contract award. Missing, incomplete, or erroneous data may delay or prevent verification of supplier eligibility. Suppliers are strongly encouraged to verify their tax status and resolve any outstanding tax liabilities or missing tax returns prior to submission. The form emphasizes that no prohibited source may receive contract award, making accurate and complete tax compliance documentation essential for bid consideration. Submission of the completed form should be directed to the Georgia Department of Revenue via email at tsd-state-contractors@dor.ga.gov in accordance with the Georgia Procurement Manual.
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| File | Type | Posted |
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| 26_34 ERATE Wireless MANDATORY SCORED QUESTIO.xls | XLS spreadsheet | |
| 26_34 MANDATORY RESPONSE WORKSHEET.xls | XLS spreadsheet | |
| JCSS STANDARD TERMS AND CONDITIONS.pdf | ||
| 26_34 ERATE Wireless eRFP.pdf | ||
| 26_34 GENERAL INFORMATION WORKSHEET.doc | DOC document | |
| 26_34 E_RATE Wireless Pre_Bid Meeting Zoom L.doc | DOC document | |
| 26_34 ERATE Wireless COST WORKSHEET.xls | XLS spreadsheet | |
| District Certifications Form.pdf | ||
| Certificate of NonCollusion.pdf | ||
| W_9.pdf | ||
| DEPARTMENT OF AUDITS IMMIGRATION AND SECURITY.pdf | ||
| 26_34 MDF Scope of Work.pdf |
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Text version
TAX COMPLIANCE
INSTRUCTIONS TO SUPPLIERS
Please complete the following information:
· Supplier’s Name:
· Physical Location Address:
· Federal Identification Number (FEI):
· Have you ever been registered in the State of Georgia?
· If so, please provide the following information, if applicable:
· State Taxpayer Identification Number (STI):
· Sales and Use Tax Number:
· Withholding Tax Number:
· What type of service will you perform?
· Will you sell any tangible personal property or goods?
· Supplier’s Affiliate’s Name:
· FEI:
· STI:
· Sales and Use Tax Number:
· Withholding Tax Number:
If there is more than one affiliate, please attach a separate sheet listing the information above.
· Person responsible for handling supplier’s tax issues (such as the CFO, the company tax officer, etc.):
· Name:
· Telephone Number:
· E-mail Address:
NOTICE TO SUPPLIER:
In the event the supplier is considered for contract award, the information provided in the form will be submitted by the State Entity to the Georgia Department of Revenue (“DOR”) for a determination as to whether the supplier is a “prohibited source” (as defined by O.C.G.A. §50-5-82) or whether there are any other outstanding tax issues. MISSING, INCOMPLETE, OR ERRONEOUS DATA MAY DELAY OR PROHIBIT VERIFICATION OF YOUR ELIGIBILITY FOR CONTRACT AWARD. NO PROHIBITED SOURCE MAY RECEIVE CONTRACT AWARD; THEREFORE, YOU ARE STRONGLY ENCOURAGED TO CHECK YOUR TAX STATUS NOW AND RESOLVE ANY OUTSTANDING TAX LIABILITIES AND/OR MISSING TAX RETURNS.
STATE ENTITY: Please submit this form via email to DOR at tsd-state-contractors@dor.ga.gov for processing in accordance with the Georgia Procurement Manual.
Revised: 12/22/2010
SPD-SP045
An Equal Opportunity Employer
File details come from the government source that posted it. Updated .