RoboCam F12 Especificações Página 45

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NONCOLLUSIONFORMANDTAXCOMPLIANCEFORM
CERTIFICATEOFNONCOLLUSION
Theundersignedcertifiesunderpenaltiesofperjurythatthisbidorproposalhasbeenmadeand
submittedingoodfaithandwithoutcollusionorfraudwithanyotherperson.Asusedinthis
certification,theword“person”shallmeananynaturalperson,business,partnership,corporation,union,
committee,club,orother
organization,entityorgroupofindividuals.Theundersignedcertifiesthatno
representationsmadebyanyCityofficials,employees,entity,orgroupofindividualsotherthanthe
PurchasingAgentoftheCityofWalthamwasrelieduponinthemakingofthisbid
_____________________________________,______________
(Signatureofpersonsigningbidorp roposal) Date
_____________________________________
(Nameofbusiness)

TAXCOMPLIANCECERTIFICATION
PursuanttoM.G.L.c.62C,&49A,Icertifyunderthepenaltiesofperjurythat,tothebestofmy
knowledgeandbelief,IamincompliancewithalllawsoftheCommonwealthrelatingtotaxes,reporting
ofemployeesandcontractors,andwithholdingandremittingchildsupport.
________________________________________,_____________
Signature
ofpersonsubmittingbidorproposal Date
________________________________________
Nameofbusiness
NOTE
Failuretosubmitanyoftherequireddocuments,inthisorinothersections,withyourbidresponse
packagemaycausethedisqualificationofyourproposal.
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