Contractor Data and Certification Sample Clauses

Contractor Data and Certification. Contractor Tax Identification and Insurance Information. Contractor shall provide Contractor’s Social Security number or Contractor’s federal tax ID number and the additional information set forth below. This information is requested pursuant to ORS 305.385 and OAR 125-020-0410(3). Social Security Numbers provided pursuant to this Section will be used for the administration of state, federal and local tax laws. Please print and/or type the following information: Name (exactly as filed with the IRS) Address Telephone: ( ) - Facsimile: ( ) - Citizenship (check one): Nonresident alien [ ] YES [ ] No Proof of Insurance: Insurance Company Policy # Expiration Date: Auto Insurance Company . Policy # Expiration Date: Business Designation (check one): [ ] Professional Corporation [ ] Partnership [ ] Limited Partnership [ ] Limited Liability Company [ ] Limited Liability Partnership [ ] Corporation [ ] Sole Proprietorship [ ] Other Social Security # or Federal Tax I.D.# Above Payment and Insurance information must be provided prior to contract approval. Contractor shall provide proof of Insurance upon request by DEPARTMENT or DEPARTMENT designee. DEPARTMENT may report the information set forth above to the Internal Revenue Service (IRS) under the name and social security number or taxpayer identification number provided.

Contractor Data and Certification. Contractor Information. Contractor shall provide the information required as set forth below. This information is requested pursuant to ORS 305.385.

Contractor Data and Certification