Town_of_Manchester_Living_Wage_Certification_Form.pdf
PDF 280 KB Posted
- Solicitation number
- 25/26-62
- Issued by
- Hartford County, Connecticut
About this file
This is a Living Wage Certification Form issued by the Town of Manchester, Connecticut, as a mandatory submission requirement for the Parking Lot Reconstruction project at Salters Pool (Bid No. 25/26-62). Bidders are required to complete and return this form with their bid submission, with failure to do so resulting in bid rejection. The form requires bidders to declare their status as either a covered employer subject to Manchester's Living Wage Ordinance (Chapter 212 of the Manchester Code of Ordinances, Sections 212-1 through 212-11) or to identify applicable exemptions. Sealed bids for this project are due by 2:00 pm on Thursday, July 23, 2026, via the Town's eProcurement Portal, at which time bids will be publicly opened and read aloud.
Bidders claiming exemption from the living wage requirements must indicate their basis for exemption by selecting one or more applicable categories: employing fewer than twenty-five eligible employees, having an annual contract value less than $25,000, or qualifying as a charitable foundation, charitable trust, or nonprofit organization with federal tax-exempt status under Internal Revenue Code Section 501. Covered employers must certify their commitment to pay the required living wage to eligible employees and comply with all ordinance requirements throughout the contract term. The form requires certification by an officer, owner, or authorized representative of the bidding company, with signature, printed name, date, bid number, and bid name.
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Text version
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.
If you are not a covered employer, please indicate the reason 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.
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