Representative of a prospective contractor means an officer or director of a corporation, a member or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor.
Representative of a prospective contractor means an officer or director of a corporation, a member or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor. Name(s) of Applicable Public Official(s) if any: _ (Completed by State Agency or Local Public Body) DISCLOSURE OF CONTRIBUTIONS BY PROSPECTIVE CONTRACTOR: Contribution Made by: Relation to Prospective Contractor: Date Contribution(s) Made: Amount(s) of Contribution(s) Nature of Contribution(s) Purpose of Contribution(s) (Attach extra pages if necessary) Signature Date Title (position) --OR— NO CONTRIBUTIONS IN THE AGGREGATE TOTAL OVER TWO HUNDRED FIFTYDOLLARS ($250) WERE MADE to an applicable public official by me, a family member or representative. Signature Date Title (Position)
Representative of a prospective contractor means an officer or director of a corporation, a member or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor. Name(s) of Applicable Public Official(s) if any: _ (Completed by State Agency or Local Public Body) DISCLOSURE OF CONTRIBUTIONS BY PROSPECTIVE CONTRACTOR: Contribution Made By: Relation to Prospective Contractor: Date Contribution(s) Made: Amount(s) of Contribution(s) Nature of Contribution(s) Purpose of Contribution(s) (Attach extra pages if necessary) Signature Date Title (position) --OR— NO CONTRIBUTIONS IN THE AGGREGATE TOTAL OVER TWO HUNDRED FIFTYDOLLARS ($250) WERE MADE to an applicable public official by me, a family member or representative. Signature Date Title (Position)APPENDIX C Resident Veterans Preference Certification (NAME OF CONTRACTOR) hereby certifies the following in regard to application of the resident veterans’ preference to this procurement.
More Definitions of Representative of a prospective contractor
Representative of a prospective contractor means an officer or director of a corporation, a member or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor. Name(s) of Applicable Public Official(s) if any: _ (Completed by State Agency or Local Public Body) DISCLOSURE OF CONTRIBUTIONS BY PROSPECTIVE CONTRACTOR: Contribution Made by:Relation to Prospective Contractor: Date Contribution(s) Made: Amount(s) of Contribution(s) Signature Date Title (position) --OR— NO CONTRIBUTIONS IN THE AGGREGATE TOTAL OVER TWO HUNDRED FIFTYDOLLARS ($250) WERE MADE to an applicable public official by me, a family member or representative. Signature Date Title (Position) APPENDIX CResident Veterans Preference Certification (NAME OF CONTRACTOR) hereby certifies the following in regard to application of the resident veterans’ preference to this procurement. Please check the box below: I declare under penalty of perjury that my business prior year revenue starting January 1 ending December 31 allows me the 10% preference discount on this solicitation. I understand that knowingly giving false or misleading information about this fact constitutes a crime.
Representative of a prospective contractor means an officer or director of a
Representative of a prospective contractor means an officer or director of a corporation, a member or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor. Name(s) of Applicable Public Official(s) if any: (Completed by State Agency or Local Public Body) DISCLOSURE OF CONTRIBUTIONS BY PROSPECTIVE CONTRACTOR: Contribution Made By: Relation to Prospective Contractor: Date Contribution(s) Made: Amount(s) of Contribution(s) Nature of Contribution(s) Purpose of Contribution(s) (Attach extra pages if necessary) Signature Date Title (position) --OR— NO CONTRIBUTIONS IN THE AGGREGATE TOTAL OVER TWO HUNDRED FIFTYDOLLARS ($250) WERE MADE to an applicable public official by me, a family member or representative. Signature Date Title (Position)APPENDIX C DRAFT CONTRACTThe Agreement included in this Appendix C represents the contract the Agency intends to use to make an award. The State of New Mexico and the Agency reserve the right to modify the Agreement prior to, or during, the award process, as necessary.
Representative of a prospective contractor means an officer or director of a corporation, a member or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor. Name(s) of Applicable Public Official(s) if any:_________________________(Completed by State Agency or Local Public Body) DISCLOSURE OF CONTRIBUTIONS BY PROSPECTIVE CONTRACTOR: Contribution Made By: __________________________________________ Relation to Prospective Contractor: __________________________________________ Date Contribution(s) Made: __________________________________________ __________________________________________Amount(s) of Contribution(s) __________________________________________ __________________________________________Nature of Contribution(s) __________________________________________ __________________________________________Purpose of Contribution(s) __________________________________________ __________________________________________(Attach extra pages if necessary)
Representative of a prospective contractor means an officer or director of a corporation, a member or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor.DISCLOSURE OF CONTRIBUTIONS: Contribution Made By: Relation to Prospective Contractor: Name of Applicable Public Official: Date Contribution(s) Made: Amount(s) of Contribution(s): Nature of Contribution(s): Purpose of Contribution(s): (Attach extra pages if necessary) Signature Date Title (position) NO CONTRIBUTIONS IN THE AGGREGATE TOTAL OVER TWO HUNDRED FIFTY DOLLARS ($250) WERE MADE to an applicable publicofficial by me, a family member, or representative. Signature Date Title (position)BID FORMResident / Veterans Preference Certification (NAME OF CONTRACTOR) hereby certifies the following in regard to application of the resident veterans’ preference to this procurement: Please check one box only Veteran Resident Businesses:□ I declare under penalty of perjury that my business prior year revenue starting January 1 ending December 31 is less than$1M allowing me the 10% preference discount on this solicitation. I understand that knowingly giving false or misleading information about this fact constitutes a crime. □ I declare under penalty of perjury that my business prior year revenue starting January 1 ending December 31 is more than$1M but less than $5M allowing me the 8% preference discount on this bid or proposal. I understand that knowingly giving false or misleading information about this fact constitutes a crime. □ I declare under penalty of perjury that my business prior year revenue starting January 1 ending December 31 is more than$5M allowing me the 7% preference discount on this bid or proposal. I understand that knowingly giving false or misleading information about this fact constitutes a crime. Resident Businesses:□ I declare under penalty of perjury that my business is a New Mexico resident business allowing me the 5% preference discount on this bid or proposal. I understand that knowingly giving false or misleading information about this fact constitutes a crime.
Representative of a prospective contractor means an officer or director of a corporation, a member or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor. Name(s) of Applicable Public Official(s) if any: Mayor Alan M Webber Councilor Signe Lindell, Pro-tem Councilor Renee Villarreal Councilor Michael Garcia Councilor Carol Romero-Wirth Councilor Lee GarciaCouncilor Christopher Rivera Councilor Amanda Chavez Councilor Jaime Cassutt DISCLOSURE OF CONTRIBUTIONS BY PROSPECTIVE CONTRACTOR: Contribution Made By: Relation to Prospective Contractor: Date Contribution(s) Made: Amount(s) of Contribution(s) Nature of Contribution(s) Purpose of Contribution(s) (Attach extra pages if necessary) Signature Date Title (position) --OR— NO CONTRIBUTIONS IN THE AGGREGATE TOTAL OVER TWO HUNDRED FIFTYDOLLARS ($250) WERE MADE to an applicable public official by me, a family member or representative. Signature Date Title (Position)
Representative of a prospective contractor means an officer or director of a corporation, a member, or manager of a limited liability corporation, a partner of a partnership or a trustee of a trust of the prospective contractor.DISCLOSURE OF CONTRIBUTIONS: Contribution Made By: _ Relation to Prospective Contractor: Name of Applicable Public Official: Date Contribution(s) Made: Amount(s) of Contribution(s): Nature of Contribution(s): Purpose of Contribution(s): (Attach extra pages if necessary) _Name Title _Signature Date ─OR─ NO CONTRIBUTIONS IN THE AGGREGATE TOTAL OVER TWO HUNDRED FIFTY DOLLARS ($250) WERE MADE to an applicablepublic official by me, a family member, or representative. _Name Title _Signature Date CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS(please return with Offer) The prospective participant certifies to the best of its knowledge and belief that it and its principals: Debarment: Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by any Federal department or agency. Have not within a three year period preceding this proposal been convicted of all has a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal of State Antitrust statues or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property. Are not presently indicted for otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses in enumerated in paragraph (2) of this certification and Have not within a three year period preceding this proposal had one or more public transaction (Federal, State, or local) terminated for cause or default.