REQUEST FOR BID. MASTER SERVICES CONTRACT Demolition Services University of Massachusetts - Lowell, Massachusetts. UMASS Bid #CL13-HT-0049

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REQUEST FOR BID

MASTER SERVICES CONTRACT

Demolition Services

University of Massachusetts - Lowell, Massachusetts

UMASS Bid #CL13-HT-0049

PREPARED FOR

University of Massachusetts - Lowell One University Avenue Lowell, Massachusetts 01854

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UMASS Lowell $25K-$100K LETTER OF INTENT

5/2006 Page 1 of 1

This checklist is provided as guidance and assistance to bidders to avoid technical mistakes resulting in rejection of a bid.

This in no way changes, affects, or supersedes the provisions set-forth in M.G.L. c.149 §44A-J or any other sections or provisions contained in the contract documents.

DO NOT BIND INTO PROJECT MANUAL

ATTENTION BIDDERS

To ensure that your bids are acceptable to the University of Massachusetts - Lowell, and are not rejected due to mistakes, we are providing this Checklist for your convenience.

GENERAL BIDDERS

1. Have you used the appropriate bid form provided for this specific project?

2. Do your bid amounts, as expressed in figures and words, coincide? The amount expressed n words shall control.

3. Have you added any information not called for, or acknowledged an addendum or alternate that does not exist, which would make your bid conditional or obscure, and lead to a bid protest?

4. Is your Bid Form SIGNED and dated?

5. Bid Deposits

a. Is your bid deposit, if in the form of a bid bond, issued from a bonding company licensed to do business in the Commonwealth of Massachusetts?

b. Is it signed by you and the bonding company?

c. Is your bid deposit made payable to the University of Massachusetts - Lowell? Bid deposits made payable to the city, town, commonwealth, or architect will cause the bid to be rejected.

d. Is your bid deposit at least five (5%) of the largest possible bid amount, considering all alternates?

PASSBOOKS,LETTERS OF CREDIT, AND DEEDS TO PROPERTY ARE NOT ACCEPTABLE AS A BID DEPOSIT.

7. Have you acknowledged every alternate?

8. If an alternate price is requested and you estimate that there is no change in price, did you indicate by writing "no change", "N/C" or "0"?

LEAVING THIS SPACE BLANK, ON YOUR BID FORM, WHEN ALTERNATES ARE REQUESTED MAY LEAD TO REJECTION OF YOUR BID.

9. Have you acknowledged all addenda issued, and followed the instructions contained therein? 10. Have you provided a completed copy of the following documents?

a) Form for General Bid b) Bid Bond

c) General Contractor Update Statement d) DCAM Certificate of Eligibility

e) Completed and signed General Contractor Update Statement f) Signed Certificate of Vote of Authorization

g) Signed Statement of State Tax Compliance h) Signed Certificate of Non Collusion

i) Signed Form of Contractor’s Equal Employment Certification j) Bid bond in the amount of 5%

k) Evidence of Insurance at the amounts stated in Article 16 of the General Conditions l) Copy of the Superintendence License and current OSHA Training Certificate m) Completed W-9 Form

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Master Services Contract – Demolition Services 5/17/13 University of Massachusetts - Lowell

TABLE OF CONTENTS

Number of Pages

TITLE SHEET FOR PROJECT MANUAL ... 1

TABLE OF CONTENTS ... 1

REQUEST FOR BID ... 2

BIDDING DOCUMENTS INSTRUCTIONS TO BIDDERS ... 3

FORM FOR GENERAL BID ... 2

PRIME/GENERAL CONTRACTOR UPDATE STATEMEN (Form CQ3) ... 10

FORMS FORM OF OWNER/CONTRACTOR AGREEMENT ... 1

FORM OF CORPORATE VOTE ... 1

FORM OF CONTRACTOR'S EQUAL EMPLOYMENT CERTIFICATION... 1

FORM OF PERFORMANCE BOND... 1

FORM OF PAYMENT BOND ... 1

STATEMENT OF STATE TAX COMPLIANCE ... 1

CERTIFICATE OF NON COLLUSION ... 1

W-9 REQUEST FOR TAXPAYER IDENTIFICATION ... 2

CONTRACT DOCUMENTS GENERAL CONDITIONS OF CONTRACT ... 29

SPECIFICATIONS DIVISION 1 - GENERAL REQUIREMENTS SECTION 01010 - SUMMARY OF WORK ... 1

SECTION 01050 - CONDUCT OF WORK ... 2

SECTION 01100 - LABOR REGULATIONS (36 Pages of Wage Rates) ... 1

SECTION 01510 - PROTECTION ... 2

SECTION 01520 - CLEANING UP ... 2

SECTION 01700 - PROJECT CLOSEOUT ... 3 Attachments

Attachment J – Sample Demolition Specification

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Master Services Contract – Demolition Services 5/17/2013 University of Massachusetts - Lowell

REQUEST FOR BID Page 1 of 3

REQUEST FOR BID

The

University of Massachusetts - Lowell

, the Awarding Authority, invites sealed bids from

General Contractors

for the

Master Services Contract – Demolition Services

for the

University of Massachusetts

in Lowell, Massachusetts.

The project consists of but is not limited to, demolishing and disposing of the building including

all components, utility connections back to street, breaking up and legal disposal of the concrete

slab, foundation walls and footings, filling and compaction of the cellar hole and area with

approved fill, preparing the sub-grade, grading and seeding, and the disposal of all material

according to State and Federal Regulations. The University must have secured commitments to

demolish several properties over the next two years. The specific scope of work will be bid to

pre-qualified contractors by “work order” and will have a value between $25,000 and $100,000

per work order.

See attached Attachment J

The work is estimated to cost

$400,000

per year.

General bidders must be Prime/General Contractor certified by the Division of Capital Asset

Management (DCAM) in the following category of work

Demolition

and must submit with its bid a

Certificate of Eligibility and signed Update Statement (Form).

Bids are subject to M.G.L. c.149 §44A-J & to minimum wage rates as required by M.G.L. c.l49

§§26 to 27H inclusive. The Awarding Authority reserves the right to reject any Bid Proposal that is

not in full compliance with the Contract Specifications; to reject any or all bids wholly or in part; to

waive technicalities in accordance with Massachusetts General Law; to make awards in a manner

deemed in the best interest of the Awarding Authority; and to correct any award erroneously made

as a result of a clerical error on the part of the Awarding Authority.

Bids will be received until

2:00 p.m. on

June 12, 2013

and publicly opened, forthwith.

All Bids should be delivered to:

University of Massachusetts – Lowell, Purchasing

Department, 600 Suffolk St., Wannalancit Business Center, Suite 415, Lowell, MA 01854

and received no later than the date & time specified above.

Bids shall be accompanied by a bid deposit that is not less than five (5%) of the greatest possible

bid amount (considering all alternates), and made payable to the

University of Massachusetts –

Lowell.

The bid deposit shall be in the form of a certified, treasurer’s, cashier check or a bid bond

form a licensed surety in accordance with M.G.L. c. §149 44B (2).

Bid Forms and Contract Documents will be available for pick-up at University of Massachusetts

– Lowell, Purchasing Department, 600 Suffolk Street, Wannalancit Business Center, Suite 415,

Lowell, MA 01854 by email via Purchasing@uml.edu

.

There is no requirement for minority and women-owned business participation for this contract.

GENERAL INFORMATION:

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Master Services Contract – Demolition Services 5/17/2013 University of Massachusetts - Lowell

1. All terms, conditions, requirements and procedures included in this Request for Bid must be

met for a Bidder to be determined as responsive. If a Bidder fails to meet any material terms,

conditions, requirement or procedure, the Bidders response may be deemed non-responsive

and rejected.

2. Unless otherwise specified, all communications, responses and documentation must be in

English; all measurements must be in feet, inches and pounds; and all cost proposals or

figures in U.S. currency. All Bids must be submitted in accordance with the specified terms

and no electronic or facsimile copies of will be accepted.

3. Bidders are prohibited from communicating directly with any employee of the Awarding

Authority except as specified in this Request for Bid. The Awarding Authority’s Purchasing

Department is the only authorized party to provide any information in response to any

questions or inquiries concerning this Request for Bid.

4. All Bids and information submitted in response to this Request for Bid are subject to the

Massachusetts Freedom of Information Law, M.G.L., Chapter 66, Section 10 and to Chapter

4, Section 7, Subsection 26, regarding public access to such documents. Any statements

reserving any confidentiality or privacy rights, excepted as permitted in this Request for Bid or

otherwise inconsistent with the statues, will be void and disregarded.

5. The Awarding Authority makes no guarantee that any services or commodities will be

purchased form any contract resulting from this Request for Bid. Any estimates or past

procurement volumes referenced in this Request for Bid are included only for the convenience

of the Bidders, and are not to be relied upon as any indication of the future purchase levels.

6. Unless otherwise stated in this Request for Bid, any reference to a particular trademark, trade

name, patent, design, type, specification, producer or supplier is not intended to restrict this

Request for Bid to any manufacturer or proprietor or to constitute an endorsement of any good

or service, and the Awarding Authority will consider approved equals in accordance with

Article 4.6.3 of the General Conditions.

MINIMUM QUALIFICATIONS:

1. The Bidder must have owned or operated the company under the same name for at least five

(5) years providing services relevant to this Request for Bidding –Demolition Services

2. All personnel employed by the Contractor shall be in the steady and continuous employment

of the Contractor. In particular, the designated Project Manager and Foreman must have a

minimum of two (2) years continuous employment with the Contractor.

3. Contractors must respond as requested:

Emergency Call – Contractor must respond within one (1) hour of initial call as directed

Service Call – Contractor must respond by phone within one (1) hour and establish a

mutually agreed arrival time at the facility.

4. The Contractor must designate a person that can be reached by phone or beeper at all times

24 hours per day, 7 days per week, and 365 days per year 24 x 7 x365. Contractors must

send a qualified service person to the location and have a vehicle fully equipped with tools and

replacement parts to perform repairs or diagnosis the problem.

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Master Services Contract – Demolition Services 5/17/2013 University of Massachusetts - Lowell

REQUEST FOR BID Page 3 of 3

6. The Bidder must have adequate manpower and equipment to accomplish the work in a timely

fashion in accordance with the General Conditions. In particular, the Bidder must be able to

provide at least three (3) two-man crews on any given day.

7. The Bidder must provide certificates of insurance in the amounts indicated in Article 16 of the

General Conditions.

TERM OF CONTRACT AND OPTION TO EXTEND

The term of any contact resulting from this Request for Bid shall be for twelve (24) months. Based

on the Contractor’s performance, the Awarding Authority may elect to extend the contract for up to

twelve (12) month period up to a total of three (3) years.

If deemed to be in the best interest of the Awarding Authority, the Awarding Authority may award

up to three (3) separate contracts for these services.

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INSTRUCTIONS TO BIDDERS

Building Projects $25,000-$100,000

ARTICLE 1 - BIDDER'S REPRESENTATION

1.1 Each General Bidder (hereinafter called the "Bidder") by making a bid (hereinafter called "bid") represents that:

.1 The Bidder has read and understands the Contract Documents and the bid is made

in accordance therewith.

.2 The Bidder has visited the site and is familiar with the local conditions under which the Work has to be performed.

1.2 Failure to so examine the Contract Documents and site will not relieve any Bidder from any obligation under the bid as submitted

.

ARTICLE 2 - REQUESTS FOR INTERPRETATION

2.1 Bidders shall promptly notify the Award Authority of any ambiguity, inconsistency, or

error, which they may discover upon examination of the Contract Documents, the site, and local conditions.

2.2 Bidders requiring clarification or interpretation of the Contract Documents shall make a

written request to the Award Authority. The Award Authority will answer such requests if received seven (7) calendar days before the date for receipt of the bids.

2.3 Interpretation, correction, or change in the Contract Documents will be made by written Addendum, which will become part of the Contract Documents. Award Authority will not be held accountable for any oral interpretations, corrections, or changes.

2.4 Addenda will be mailed by the Award Authority by U.S Postal Service, certificate of

mailing, to every individual or firm on record as having taken a set of Contract Documents.

2.5 Copies of addenda will be made available for inspection at the locations listed in the

Advertisement where Contract Documents are on file.

ARTICLE 3 - PREPARATION AND SUBMISSION OF BIDS

3.1 Bids shall be submitted on the "Form for General Bid" furnished at no cost by UMASS

Lowell. The forms enclosed in the Project Manual shall not be extracted or used. Additional forms are available at the location listed in the Advertisement.

3.2 All entries on the bid form shall be made by typewriter or in ink.

3.3 Where so indicated on the bid form, sums shall be expressed in both words and figures.

Where there is a discrepancy between the bid sum expressed in words and the bid sum expressed in figures, the words shall control.

3.4 Bid Deposits shall be:

.1 at least five percent (5%) of the greatest possible bid amount, considering all

alternates;

.2 made payable to the University of Massachusetts - Lowell;

.3 conditioned upon faithful performance by the principal of the agreements contained in

the bid, and

.4 in the form of: a. cash,

b. certified check, treasurer’s or cashier’s check issued by a responsible bank or trust company, or c. a bid bond issued by a surety company licensed to do business in the Commonwealth of

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Instructions to Bidders 2 of 3

3.5 Bid deposits of the three (3) lowest responsible and eligible General Bidders shall be

retained until the execution and delivery of the Owner/Contractor Agreement.

3.6 The General Bid Form and the bid deposit shall be enclosed in a sealed envelop with the

following plainly marked on the outside:

General Bid for:

Project Name / Project Number

Bidder's Name, Business Address, and Phone Number 3.7 Date and time for receipt of bids is set forth in the Advertisement.

3.8 Timely delivery of a bid to the location designated shall be the full responsibility of the

Bidder.

ARTICLE 4 - ALTERNATES

4.1 Each General Bidder shall acknowledge Alternates in Section C on the Form for General

Bid by entering the dollar amount of addition or subtraction necessitated by the Alternate.

4.2 In the event an Alternate does not involve a change in the amount of the base bid, the Bidder shall so indicate by writing "No Change", or "N/C" or "0" in the space provided

for that Alternate.

4.4 General Bidders shall enter on the Form for General Bid a single amount for each Alternate which shall consist of the amount for work performed as a result of the alternate.

4.5 The low Bidder will be determined on the basis of the sum of the base bid and the accepted

alternates.

ARTICLE 5 - WITHDRAWAL OF BIDS

5.1 Before Opening of Bids

5.1.1 Any bid may be withdrawn prior to the time designated for receipt of bids upon written

request. Withdrawal of bids must be confirmed over the Bidder's signature by written notice post-marked or sent by facsimile on or before the date and time set for receipt of bids.

5.1.2 Withdrawn bids may be resubmitted up to the time designated for the receipt of bids. 5.2 After Opening of Bids

5.2.1 Bidders may withdraw a bid, without penalty, any time up to the time of Award as

defined in paragraph 8.1, and upon demonstrating, to the satisfaction of UMASS Lowell, that a bona fide clerical error was made during the preparation of the bid. Failure to conclusively demonstrate a bona fide clerical error may result in forfeiture of the bid deposit.

ARTICLE 6 - CONTRACT AWARD

6.1 Award means both the determination and selection of the lowest, responsible and

eligible bidder(s), by University of Massachusetts - Lowell.

6.2 The University of Massachusetts - Lowell will award the contract to the lowest responsible and

eligible bidder(s) within thirty days, Saturdays, Sundays, and legal holidays excluded after the opening of bids in accordance with M.G.L. c.149 §44A.

6.3 The award of this Contract is subject to the approval of the University of Massachusetts

-Lowell. Contracts without approval shall not be considered valid.

6.4 The University of Massachusetts - Lowell reserves the right to waive any informalities in

or to reject any or all Bids if it be in the public interest to do so.

6.5 As used herein, the term "lowest responsible and eligible bidder" shall mean the General

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and integrity necessary for the faithful performance of the work, and who meets the requirements for Bidders set forth in M.G.L. c.l49 §44A-J and is not debarred from bidding under M.G.L. c.l49 §44C; and who shall certify that they are able to furnish labor that can work in harmony with all other elements of labor employed or to be employed on the work.

ARTICLE 7 - FORMS REQUIRED FOR CONTRACT APPROVAL

7.1 Upon Award, the General Bidder shall complete the following forms to ensure prompt

contract validation. These forms will be provided to the selected General Bidder by UMASS - Lowell. Submit (3) originals of each.

7.2 Owner/Contractor Agreement and Form of Corporate Vote.

7.3 Form of Contractor's Equal Employment Certification in accordance with Article 14 of the General Conditions.

7.4 Form of Performance Bond and Form of Payment Bond must be submitted by the General

Contractor on UMASS Lowell's form, in accordance with the General Conditions. The dates on the bonds must coincide with the contract date, and a current Power-of-Attorney must be attached to each bond.

7.5. Insurance Certificates for the General Contractor are required and must be submitted

in accordance with the General Conditions.

7.5.1 General Contractors must indicate on special perils insurance or installation floater if stored materials are covered.

ARTICLE 8 - CONTRACT VALIDATION

8.1 The Owner-Contractor Agreement shall not be valid until signed by the Director of

Purchasing.

8.2 The Notice to Proceed for construction shall not be issued until the Owner/Contractor

Agreement has been validated by the Director of Purchasing.

8.3 Incomplete or unacceptable submissions of forms required by paragraphs 7.2 - 7.5 will

delay the validation of the Owner/Contractor Agreement by Purchasing.

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FORM OF GENERAL BID 1 of 2

FORM OF GENERAL BID

TO THE AWARDING AUTHORITY

A. The undersigned proposes to furnish all labor and materials required for Master Services Contract –

Demolition Services

for the

UNIVERSITY OF MASSACHUSETTS - LOWELL in Lowell, Massachusetts

in accordance with Contract Documents prepared by

University of Massachusetts - Lowell

For the contract price specified below, subject additions and deductions according to the terms of the specifications

B. This bid includes addenda number(s)

C. The proposed contract price is: Total of items #1, and #2 below.

Dollars $

Bid Amount in Words Bid Amount in Numbers

Labor and Material Pricing: The hourly labor price is to include prevailing wage rate, insurances, taxes,overhead, tools, equipment, vehicles required and profit for each trade. Include a price for

each line item based on the quantities identified as the base bid hours. The supervisor, demo laborer, equipment and all other personnel used by the Bidder must be direct employees of the Contractor. The hourly rates indicated will be used for additional work over the quantities in the base bid amount. The rates will be reviewed and adjusted after the first 24 months of the contract.

Item #1: Regular Time – Monday -Friday 7:00 a.m. to 5:00 p.m. Trade Base Bid Proposed Hourly Rate

Supervisor

500 hours

x $ /hour = $

Demo Laborer

3000 hours x $ /hour = $

Equipment

Operator

5000 hours x $ /hour = $

Item #1 Sub Total

= $

Item #2: Premium Time – Saturday, Sunday, Holidays, Monday -Friday 5:01 p.m. to 6:59 a.m. Trade Base Bid Proposed Hourly Rate

Supervisor

500 hours

x $ /hour = $

Demo Laborer

1000 hours x $ /hour = $

Equipment

Operator

2000 hours x $ /hour = $

Item #2 Sub Total

= $

See below for allowable compensation for sub-trade work and materials.

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Sub-Trade and Material pricing:

1 The Contractor will be required at the discretion of the University to obtain a minimum of three proposals

for work in each sub-trade unless otherwise directed by University of Massachusetts - Lowell. The Contractor will submit the three proposals for review and approval. The Contractor will be compensated for the direct costs of the sub-trade work and a 10% mark-up in accordance in Article 8.3.1.g of the General Conditions.

2 The Contractor will be required to submit copies of the material invoices for review by the University of

Massachusetts – Lowell. The Contractor will be compensated for the direct costs of the materials and a 15% mark-up and in accordance with Article 8.3.1.f of the General Conditions. The University of

Massachusetts – Lowell reserves the right to purchase and supply the materials to the Contractor for the work order. If the materials are furnished, the Contractor will get no mark-up for the materials.

D. The undersigned agrees that, if selected as general contractor, we will within five days, Saturdays,

Sundays, and legal holidays excluded, after presentation thereof by the awarding authority, execute a contract in accordance with the terms of this bid and furnish a performance bond and also a labor and materials or payment bond, each of a surety company qualified to do business under the laws of the Commonwealth and satisfactory to the awarding authority and each in the sum of the contract price, the premiums for which are to be paid by the general contractor and are included in the contract price. The undersigned hereby certifies that he is able to furnish labor that can work in harmony with all other elements of labor employed or to be employed on the work; that all employees to be employed at the work site will have successfully completed a course in construction safety and health approved by the United States Occupational Safety and Health Administration that is at least 10 hours in duration at the time the employee begins work and who shall furnish documentation of successful completion of said course with the first certified payroll report for each employee; and that he will comply fully with all laws and regulations applicable to awards made subject to section 44A. The Safety Training requirement in this paragraph is effective July 1, 2006.

The undersigned further certifies under the penalties of perjury that this bid is in all respects bona fide, fair and made without collusion or fraud with any other person. As used in this subsection the word "person" shall mean natural person, joint venture, partnership, corporation or other business or legal entity. The undersigned further certifies under penalty of perjury that the said undersigned is not presently debarred from doing public construction work in the Commonwealth under the provisions of section twenty-nine F of chapter twenty-nine, or any other applicable debarment provisions of any other chapter of the General Laws or any rule or regulation promulgated thereunder.

Name of General Bidder

Signature

BY:

Signature & Title of person signing bid

Date:

Business Address

(City and State)

Note: If the bidder is a corporation, indicate state of incorporation under signature, and affix corporate seal; if a partnership, give full names and residential addresses of partners if different from business addresses.

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Division of Capital Asset Management Page 1 of 10 Prime/General Contractor Update Statement Effective January 1, 2010, may be used prior

SPECIAL NOTICE TO AWARDING AUTHORITY

BIDDERS’ UPDATE STATEMENTS ARE NOT PUBLIC RECORDS AND

ARE NOT OPEN TO PUBLIC INSPECTION (M.G.L. C.149, §44D)

EFFECTIVE JANUARY 1, 2010

Commonwealth of Massachusetts

Division of Capital Asset Management

PRIME/GENERAL CONTRACTOR

UPDATE STATEMENT

TO ALL BIDDERS AND AWARDING AUTHORITIES

A COMPLETED AND SIGNED PRIME/GENERAL CONTRACTOR UPDATE

STATEMENT MUST BE SUBMITTED WITH EVERY PRIME/GENERAL BID FOR A

CONTRACT PURSUANT TO M.G.L. c.149, §44A AND M.G.L. c. 149A. ANY

PRIME/GENERAL BID SUBMITTED WITHOUT AN APPROPRIATE UPDATE

STATEMENT IS INVALID AND MUST BE REJECTED.

Caution: This form is to be used for submitting Prime/General Contract bids. It is

not to be used for submitting Filed Sub-Bids or Trade Sub-Bids.

AWARDING AUTHORITIES

If the Awarding Authority determines that the bidder does not demonstrably possess

the skill, ability, and integrity necessary to perform the work on the project, it must

reject the bid.

BIDDER’S AFFIDAVIT

I swear under the pains and penalties of perjury that I am duly authorized by the bidder

named below to sign and submit this Prime/General Contractor Update Statement on behalf

of the bidder named below, that I have read this Prime/General Contractor Update Statement,

and that all of the information provided by the bidder in this Prime/General Contractor Update

Statement is true, accurate, and complete as of the bid date.

_ _

_ _

Bid Date

Print Name of Prime/General Contractor

_ _

_ _

Project Number (or

Business Address

name if no number)

_ _

_ _

Awarding Authority

Telephone Number

SIGNATURE

_____________________________________

Bidder’s Authorized Representative

Information you provide herein must supplement your firm’s most recent DCAM Application for Prime/General Contractor Certificate of Eligibility. You must report all requested information not previously reported on your most recent DCAM Application.

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INSTRUCTIONS TO BIDDERS

 This form must be completed and submitted by all Prime/General contractors bidding on projects pursuant to M.G.L. c. 149, §44A and M.G.L. c. 149A.

 You must give complete and accurate answers to all questions and provide all of the information requested. MAKING A MATERIALLY FALSE STATEMENT IN THIS UPDATE STATEMENT IS GROUNDS FOR

REJECTING YOUR BID AND FOR DEBARRING YOU FROM ALL PUBLIC CONTRACTING.

Information you provide herein must supplement your firm’s most recent DCAM Application for Prime/General Contractor Certificate of Eligibility. You must report all requested information not previously reported on your most recent DCAM Application.

 You must use this official form of Update Statement. Copies of this form may be obtained from the awarding authority and from the Asset Management Web Site:

www.mass.gov/dcam .

 If additional space is needed, please copy the

appropriate page of this Update Statement and attach it as an additional sheet.

 See the section entitled “Bidding Limits” in the

Instructions to Awarding Authorities for important

information concerning your bidding limits.

INSTRUCTIONS TO AWARDING AUTHORITIES

Determination of Bidder Qualifications

 It is the awarding authority’s responsibility to determine who is the lowest eligible and responsible bidder. You must consider all of the information in the low bidder’s Update Statement in making this determination. Remember: this information was not available to the Division of Capital Asset Management at the time of certification.

 The bidder’s performance on the projected listed in Parts 1 and 2 must be part of your review. Contact the project references.

 AWARDING AUTHORITIES ARE STRONGLY

ENCOURAGED TO REVIEW THE LOW BIDDER’S ENTIRE CERTIFICATION FILE AT THE DIVISION OF

CAPITAL ASSET MANAGEMENT. Telephone (617)

727-9320 for an appointment.

Bidding Limits

Single Project Limit: The total amount of the bid, including all alternates, may not exceed the bidder’s Single Project Limit.

Aggregate Work Limit: The annual value of the work to be performed on the contract for which the bid is submitted, when added to the annual cost to complete the bidder’s

other currently held contracts, may not exceed the bidder’s Aggregate Work Limit. Use the following procedure to determine whether the low bidder is within its Aggregate Work Limit:

Step 1 Review Update Statement Question #2 to make sure that all requested information is provided and that the bidder has accurately calculated and totaled the annualized value of all incomplete work on its currently held contracts (column 9).

Step 2 Determine the annual dollar value of the work to be performed on your project. This is done as follows:

(i) If the project is to be completed in less than 12 months, the annual dollar value of the work is equal to the full amount of the bid.

(ii) If the project will take more than 12 months to complete, calculate the number of years given to complete the project by dividing the total number of months in the project schedule by 12 (calculate to 3 decimal places), then divide the amount of the bid by the calculated number of years to find the annual dollar value of the work. Step 3 Add the annualized value of all of the bidder’s

incomplete contract work (the total of column 9 on page 5) to the annual dollar value of the work to be performed on your project. The total may not exceed the bidder’s Aggregate Work Limit.

Correction of Errors and Omissions in Update Statements

Matters of Form: An awarding authority shall not reject a contractor’s bid because there are mistakes or omissions of form in the Update Statement submitted with the bid, provided the contractor promptly corrects those mistakes or omissions upon request of the awarding authority. [810 CMR 8.05(1)].

Correction of Other Defects: An awarding authority may, in its discretion, give a contractor notice of defects, other than mistakes or omissions of form, in the contractor’s Update Statement, and an opportunity to correct such defects, provided the correction of such defects is not prejudicial to fair competition. An awarding authority may reject a corrected Update Statement if it contains unfavorable information about the contractor that was omitted from the Update Statement filed with the contractor’s bid. [810 CMR 8.05(2)].

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Division of Capital Asset Management Page 3 of 10 Prime/General Contractor Update Statement Effective January 1, 2010, may be used prior

PART 1 - COMPLETED PROJECTS

LIST ALL PUBLIC AND PRIVATE

BUILDING

PROJECTS YOUR FIRM HAS COMPLETED SINCE YOUR MOST

RECENT DCAM APPLICATION FOR PRIME/GENERAL CONTRACTOR CERTIFICATE OF ELIGIBILITY. YOU MUST

REPORT ALL REQUESTED INFORMATION NOT PREVIOUSLY REPORTED ON YOUR MOST RECENT DCAM

APPLICATION

*

PROJECT TITLE & LOCATION WORK

CATEGORY CONTRACT PRICE START DATE COMPLETEDDATE

Attach additional sheets if necessary

*

If your firm has been terminated from a project prior to completion of the work or has failed or refused to complete its work under

any contract, full details and an explanation must be provided. See Part 3 of this Update Statement.

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PROVIDE THE FOLLOWING REFERENCE INFORMATION FOR EACH COMPLETED PROJECT LISTED ON THE

PREVIOUS PAGE.

PROJECT TITLE

COMPANY NAME CONTACT PERSON TELEPHONE

OWNER: DESIGNER: GC: OWNER: DESIGNER: GC: OWNER: DESIGNER: GC: OWNER: DESIGNER: GC: OWNER: DESIGNER: GC: OWNER: DESIGNER: GC:

Is your company or any individual who owns, manages or controls your company affiliated with any owner, designer or general

contractor named above, either through a business or family relationship?

YES

NO

Are any of the contact persons named above affiliated with your company or any individual who owns, manages or control your

company, either through a business or family relationship?

YES

NO

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Division of Capital Asset Management Page 5 of 10 Prime/General Contractor Update Statement Effective January 1, 2010, may be used prior

PART 2 - CURRENTLY HELD CONTRACTS

LIST ALL PUBLIC AND PRIVATE BUILDING AND NON-BUILDING

CONSTRUCTION

PROJECTS YOUR FIRM HAS UNDER

CONTRACT ON THIS DATE REGARDLESS OF WHEN OR WHETHER THE WORK COMMENCED.

1

2

3

4

5

6

7

8

9

PROJECT TITLE &

LOCATION CATEGORYWORK AND END START DATES

ON SCHEDULE

(yes / no)

CONTRACT

PRICE COMPLETE% NOT $ VALUE OF WORK NOT COMPLETE (col. 5 X col. 6) NO. OF YEARS REMAINING (see note below) ANNUALIZED VALUE OF INCOMPLETE WORK (col. 7 ÷ col. 8) (divided by)

ANNUALIZED VALUE OF ALL INCOMPLETE CONTRACT WORK (Total of Column 9) $_ _

Column 8 •

If less than one year is left in the project schedule, write 1.

If more than 12 months are left in the project schedule, divide the number of months left in the project schedule by 12 (calculate to three decimal places).

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PROVIDE THE FOLLOWING REFERENCE INFORMATION FOR EACH INCOMPLETE PROJECT LISTED ON THE

PREVIOUS PAGE.

PROJECT TITLE

COMPANY NAME CONTACT PERSON TELEPHONE

OWNER: DESIGNER: GC: OWNER: DESIGNER: GC: OWNER: DESIGNER: GC: OWNER: DESIGNER: GC: OWNER: DESIGNER: GC: OWNER: DESIGNER: GC:

Is your company or any individual who owns, manages or controls your company affiliated with any owner, designer or general

contractor named above either through a business or family relationship?

YES

NO

Are any of the contact persons named above affiliated with your company or any individual who owns, manages or control your

company, either through a business or family relationship?

YES

NO

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Division of Capital Asset Management Page 7 of 10 Prime/General Contractor Update Statement Effective January 1, 2010, may be used prior

PART 3 - PROJECT PERFORMANCE

For Parts 3 and 4, if you answer YES to any question, please provide on a separate page a

complete explanation. Information you provide herein must supplement your firm’s most recent

DCAM Application for Prime/General Contractor Certificate of Eligibility. You must report all

requested information not previously reported on your most recent DCAM Application.

Include

all details [project name(s) and location(s), names of all parties involved, relevant dates, etc.].

YES

NO

1. Has your firm been terminated on any contract prior to completing a project or has

any officer, partner or principal of your firm been an officer, partner or principal of

another firm that was terminated or failed to complete a project?

2. Has your firm failed or refused either to perform or complete any of its work under

any contract prior to substantial completion?

3. Has your firm failed or refused to complete any punch list work under any contract?

4. Has your firm filed for bankruptcy, or has any officer, principal or individual with a

financial interest in your current firm been an officer, principal or individual with a

financial interest in another firm that filed for bankruptcy?

5. Has your surety taken over or been asked to complete any of your work under any

contract?

6. Has a payment or performance bond been invoked against your current firm, or has

any officer, principal or individual with a financial interest in your current firm been

an officer, principal or individual with a financial interest in another firm that had a

payment or performance bond invoked?

7. Has your surety made payment to a materials supplier or other party under your

payment bond on any contract?

8. Has any subcontractor filed a demand for direct payment with an awarding authority

for a public project on any of your contracts?

9. Have any of your subcontractors or suppliers filed litigation to enforce a mechanic’s

lien against property in connection with work performed or materials supplied

under any of your contracts?

10. Have there been any deaths of an employee or others occurring in connection with

any of your projects?

11. Has any employee or other person suffered an injury in connection with any of your

projects resulting in their inability to return to work for a period in excess of one

year?

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PART 4 - Legal or Administrative Proceedings; Compliance with Laws

Please answer the following questions.

Information must supplement all judicial and

administrative proceedings involving bidder’s firm, which were instituted or concluded

(adversely or otherwise) since your firm’s most recent DCAM Application for

Prime/General Contractor Certificate of Eligibility. You must report all requested

information not previously reported on your most recent DCAM Application.

The term “administrative proceeding” as used in this Prime/General Contractor

Update Statement includes (i) any action taken or proceeding brought by a

governmental agency, department or officer to enforce any law, regulation, code,

legal, or contractual requirement, except for those brought in state or federal courts, or

(ii) any action taken by a governmental agency, department or officer imposing

penalties, fines or other sanctions for failure to comply with any such legal or

contractual requirement.

The term “anyone with a financial interest in your firm” as used in this Section “I”,

shall mean any person and/or entity with a 5% or greater ownership interest in the

applicant’s firm.

If you answer YES to any question, on a separate page provide a complete

explanation of each proceeding or action and any judgment, decision, fine or

other sanction or result. Include all details (name of court or administrative

agency, title of case or proceeding, case number, date action was commenced,

date judgment or decision was entered, fines or penalties imposed, etc.).

YES

NO

1. Have any civil, judicial or administrative proceedings involving your firm or a

principal or officer or anyone with a financial interest in your firm been brought,

concluded, or settled relating to the procurement or performance of any construction

contract, including but not limited to actions to obtain payment brought by

subcontractors, suppliers or others?

2. Have any criminal proceedings involving your firm or a principal or officer or

anyone with a financial interest in your firm been brought, concluded, or settled

relating to the procurement or performance of any construction contract including,

but not limited to, any of the following offenses: fraud, graft, embezzlement,

forgery, bribery, falsification or destruction of records, or receipt of stolen property?

3. Have any judicial or administrative proceedings involving your firm or a principal

or officer or anyone with a financial interest in your firm been brought, concluded,

or settled relating to a violation of any state’s or federal procurement laws arising

out of the submission of bids or proposals?

4. Have any judicial or administrative proceedings involving your firm or a principal

or officer or anyone with a financial interest in your firm been brought, concluded,

or settled relating to a violation of M.G.L. Chapter 268A, the State Ethics Law?

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Division of Capital Asset Management Page 9 of 10 Prime/General Contractor Update Statement Effective January 1, 2010, may be used prior

PART 4 - Legal or Administrative Proceedings; Compliance with Laws (continued)

YES

NO

5. Have any judicial or administrative proceedings involving your firm or a principal

or officer or anyone with a financial interest in your firm been brought, concluded,

or settled relating to a violation of any state or federal law regulating hours of labor,

unemployment compensation, minimum wages, prevailing wages, overtime pay,

equal pay, child labor or worker’s compensation?

6. Have any judicial or administrative proceedings involving your firm or a principal

or officer or anyone with a financial interest in your firm been brought, concluded,

or settled relating to a violation of any state or federal law prohibiting

discrimination in employment?

7. Have any judicial or administrative proceedings involving your firm or a principal

or officer or anyone with a financial interest in your firm been brought, concluded,

or settled relating to a claim of repeated or aggravated violation of any state or

federal law regulating labor relations?

8. Have any proceedings by a municipal, state, or federal agency been brought,

concluded, or settled relating to decertification, debarment, or suspension of your

firm or any principal or officer or anyone with a financial interest in your firm from

public contracting?

9. Have any judicial or administrative proceedings involving your firm or a principal or

officer or anyone with a financial interest in your firm been brought, concluded, or

settled relating to a violation of state or federal law regulating the environment?

10. Has your firm been fined by OSHA or any other state or federal agency for

violations of any laws or regulations related to occupational health or safety? Note:

this information may be obtained from OSHA’s Web Site at www.osha.gov

11. Has your firm been sanctioned for failure to achieve DBE/MBE/WBE goals,

workforce goals, or failure to file certified payrolls on any public projects?

12. Other than previously reported in the above paragraphs of this Section I, have any

administrative proceedings or investigations involving your firm or a principal or

officer or anyone with a financial interest in your firm been brought, concluded, or

settled by any local, state or federal agency relating to the procurement or

performance of any construction contract?

13. Are there any other issues that you are aware which may affect your firm’s

responsibility and integrity as a building contractor?

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PART 5 - SUPERVISORY PERSONNEL

List all supervisory personnel, such as project managers and superintendents, who will be assigned

to the project if your firm is awarded the contract.

Attach the resume of each person listed below

.

NAME

TITLE OR FUNCTION

PART 6 - CHANGES IN BUSINESS ORGANIZATION OR FINANCIAL CONDITION

Have there been any changes in your firm’s business organization, financial condition or bonding

capacity since the date your current Certificate of Eligibility was issued?

Yes

No

If YES, attach a separate page providing complete details.

PART 7 – LIST OF COMPLETED CONSTRUCTION PROJECTS SUBMITTED TO

THE DIVISION OF CAPITAL ASSET MANAGEMENT WITH FIRM’S MOST RECENT

APPLICATION FOR CERTIFICATION ALONG WITH CERTIFICATION PAGE.

Attach here a copy of the list of completed construction projects which was

submitted with your firm’s most recent Application for Prime/General

Contractor Certificate of Eligibility to the Division of Capital Asset

Management. The Attachment should include a complete copy of the entire

Section G – “Completed Projects” and the final page – “Certification”

(Section J) containing the signature and date that the Completed Projects list

(Section G) was submitted to the Division of Capital Asset Management.

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UMASS Lowell $00K-$10Mil GC EQUAL EMPLOYMENT CERTIFICATE

5/2006 Page 1 of 1

FORM OF CONTRACTOR'S EQUAL EMPLOYMENT CERTIFICATION

UNIVERSITY OF MASSACHUSETTS - LOWELL

This form must be completed and submitted by the Contractor prior to the signing of the Owner-Contractor Agreement.

This certifies that:

Contractor

Street Address

City/State/Zip Code

1. Intends to use the following listed construction trades in the work under this contract:

2. Will comply with the minority manpower ratio and specific affirmative action steps contained in

Article 14 of the Conditions of this Contract; and

3. Will obtain similar certifications from each of its subcontractors and submit to the Owner prior

to the award of any subcontract under this contract the subcontractor’s certification.

Signature of Authorized Representative of Contractor

Name and Title

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UMASS Lowell $00K-$10Mil PERFORMANCE BOND

Bond No.

PERFORMANCE BOND

UNIVERSITY OF MASSACHUSETTS - LOWELL

KNOW ALL MEN BY THESE PRESENTS:

That we, as Principal,

and as Surety, are held and firmly bound unto

the University of Massachusetts - Lowell, as Obligee, in the sum of

dollars $

to be paid to the Obligee, for which payments, well and truly to be made, we bind ourselves, our respective heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

WHEREAS, the said Principal has made a contract with the Obligee, bearing the date of 2010

for the construction of in Massachusetts

Project Title

NOW

, the condition of this obligation is such that if the Principal and all Subcontractors under said contract shall well and truly keep and perform all the undertakings, covenants, agreement, terms and conditions of said contract on its part to be kept and performed during the original term of said contract and any extensions thereof that may be granted by the Obligee, with or without notice to the Surety, and during the life and any guarantee required under the contract, and shall also well

and truly keep and perform all the undertakings, covenants, agreements, terms and conditions of any and all duly authorized modifications, alterations changes or additions to said contract that may hereafter be made, notice to the Surety

of such modifications, alterations, changes or additions being hereby waived, then this obligation shall become null and void; otherwise, it shall remain in full force and virtue.

IN THE EVENT

, that the contract is abandoned by the Principal, or in the event that the Obligee, under the provisions of Article 19 of the General Conditions of said contract terminates the employment of the Principal or the authority of the

Principal to continue the work, said Surety hereby further agrees that said Surety shall, if requested in writing by the

Obligee, take such action as is necessary to complete said contract.

IN WITNESS WHEREOF, the Principal and Surety have hereunto set their hands and seals this:

Day of 201

PRINCIPAL SURETY

BY: BY:

SEAL ATTORNEY-IN FACT

ATTEST: ATTEST

The rate for this bond is % for the first $ and % for the next $

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UMASS Lowell $100K-$10Mil PAYMENT BOND

5/2006 Page 1 of 1

Bond No.

PAYMENT BOND

UNIVERSITY OF MASSACHUSETTS - LOWELL

KNOW ALL MEN BY THESE PRESENTS:

That we, as Principal,

and as Surety, are held and firmly bound unto

the University of Massachusetts - Lowell, as Obligee, in the sum of dollars $

to be paid to the Obligee, for which payments, well and truly to be made, we bind ourselves, our respective heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

WHEREAS, the said Principal has made a contract with the Obligee, bearing the date of 2010

for the construction of in Lowell, Massachusetts

Project Title

NOW the conditions of this obligation are such that if the Principal and all subcontractors under said contract shall pay for all labor performed or furnished and for all materials used or employed in said contract and in any and all duly authorized modifications, alterations, extensions of time, changes or additions to said contract that may hereafter be made, notice to the

Surety of such modifications, alterations, extensions of time, changes or additions being hereby waived, the foregoing to

include any other purposes or items set out in, and to be subject to, provisions of M.G.L. c.30 §39A, and M.G.L. c.149 §29, as amended, then this obligation shall become null and void; otherwise it shall remain in full force and virtue.

INWITNESSWHEREOF, THE PRINCIPAL AND SURETY HAVE HEREUNTO SET THEIR HANDS AND SEALS THIS:

Day of 201

PRINCIPAL SURETY

BY: BY:

SEAL ATTORNEY-IN FACT

ATTEST: ATTEST

The rate for this bond is % for the first $ and % for the next $

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CERTIFICATE OF NON COLLUSION Page 1 of 1

CERTIFICATE OF NON COLLUSION

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.

Contracting Party / Company Name

Authorized Signature (must be in ink and signed by the person submitting the bid)

Title

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Form

UMW-9

University of Massachusetts Substitute W-9 Form

(Rev. December 2012)

Request for Taxpayer

Identification Number and Certification

Give form to the requester. Do not

send to the IRS.

P ri nt o r ty pe See S p ec ifi c In st ru ct io n s on page

3 Name (as shown on your income tax return):

Business name, if different from above:

Check appropriate box: ☐ Individual/Sole proprietor ☐ C Corporation ☐ S Corporation ☐ Partnership ☐ Trust Estate

Exempt Payee ☐ Limited liability company. Enter the tax classification: (C =Corporation, S = S Corporation, P = Partnership)

☐Other (see instructions)

Legal Address (number, Street, and apt. or suite no.): Remit Address:

City, state, and ZIP code:

Requir

e

d

Order Email Address:

Order Fax Number:

Contact Phone Number:

Vendor’s preferred method for Purchase Orders:

Email

Fax

Part I Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TINon page 4. Note: If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter.

Social security number

or

Employer identification number

Vendors:

Dunn and Bradstreet Universal Numbering System (DUNS) DUNS Part II Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and

3. I am a U.S. citizen or other U.S. person (defined below).

Certification instructions: You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the instructions on page 4.

Sign Here

Signature of

U.S. person: Date:

If you have questions on completing this form, please contact Vendor Maintenance at: (978) 934-3470.

Upon completion of this form, please return to: University of Massachusetts Department you are doing business with. (UMLOW)

Part III For University Verification Purposes Only – Do Not Write Below This Line

Business Name Acronym

☐ IRS TIN Matching ☐ OFAC Signature Date:

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-General Instructions

Section references are to the Internal Revenue Code unless otherwise noted.

Purpose of Form

A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S.

exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income.

Note. If a requester gives you a form other than Form W-9 to

request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9.

Definition of a U.S. person: For federal tax purposes, you are

considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien,

• A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States,

• An estate (other than a foreign estate), or

• A domestic trust (as defined in Regulations section 301.7701-7).

Special rules for partnerships: Partnerships that conduct a trade

or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income.

The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases:

• The U.S. owner of a disregarded entity and not the entity,

• The U.S. grantor or other owner of a grantor trust and not the trust, and

• The U.S. trust (other than a grantor trust) and not the beneficiaries of the trust.

Foreign person: If you are a foreign person, do not use Form

W-9. Instead, use the appropriate Form W-8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities).

Nonresident alien who becomes a resident alien: Generally,

only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a “saving clause.” Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes.

If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items:

1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien.

2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions.

4. The type and amount of income that qualifies for the exemption from tax.

5. Sufficient facts to justify the exemption from tax under the terms of the treaty article.

Example. Article 20 of the U.S.-China income tax treaty allows an

exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption.

If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate completed Form W-8.

What is backup withholding? Persons making certain payments

to you must under certain conditions withhold and pay to the IRS 28% of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding.

You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return.

Payments you receive will be subject to backup withholding if:

1. You do not furnish your TIN to the requester,

2. You do not certify your TIN when required (see the Part II instructions on page 3 for details),

3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding

because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only).

Certain payees and payments are exempt from backup withholding. See the instructions below and the separate Instructions for the Requester of Form W-9.

Also see Special rules for partnerships on page 1.

Figure

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