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NON‐COLLUSIONFORMANDTAXCOMPLIANCEFORM

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CERTIFICATEOFNON‐COLLUSION

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Theundersignedcertifiesunderpenaltiesofperjurythatthisbidorproposalhasbeenmadeand

submittedingoodfaithandwithoutcollusionorfraudwithanyotherperson.Asusedinthis

certification,theword“person”shallmeananynaturalperson,business,partnership,corporation,union,

committee,club,orother

organization,entityorgroupofindividuals.Theundersignedcertifiesthatno

representationsmadebyanyCityofficials,employees,entity,orgroupofindividualsotherthanthe

PurchasingAgentoftheCityofWalthamwasrelieduponinthemakingofthisbid

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_____________________________________,______________

(Signatureofpersonsigningbidorp roposal) Date

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_____________________________________

(Nameofbusiness)

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TAXCOMPLIANCECERTIFICATION

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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.

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________________________________________,_____________

Signature

ofpersonsubmittingbidorproposal Date

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________________________________________

Nameofbusiness

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NOTE

Failuretosubmitanyoftherequireddocuments,inthisorinothersections,withyourbidresponse

packagemaycausethedisqualificationofyourproposal.

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RoboCam F12 Spezifikationen Seite 45