REQUIRED FOR ALL CONTRACT TYPES
Effective Date: June 30, 2009
Form A Representation By Individual Form D New Resolution By Entity
Form B Representation By Entity Form E Prior Resolution By Entity
Form C Affidavit By Entity
The Office of the Attorney General has approved the above nondiscrimination certification forms to assist executive branch agencies in complying with the State's contracting requirements under Connecticut General Statutes §§ 4a-60(a)(1) and 4a-60a(a)(1), as amended.
By law, a contractor must provide an awarding State agency with written representation or documentation that certifies the contractor complies with the State's nondiscrimination agreements and warranties prior to the award of a contract. If after the initial submission there is any change in such representation, the contractor shall provide the updated representation to the State or such political subdivision not later than thirty (30) days after such change or upon the execution of a new contract with the state or political subdivision of the state whichever is earlier. Such contractor shall also certify no later than fourteen (14) days after the twelve (12) month anniversary of the most recently filed non-discrimination certification that the representation on file is current and accurate.
A nondiscrimination certification is generally required for all State contracts – regardless of type, term, cost, or value. **See list of exempt entities (below).**
There are five different certification forms one of which must be submitted in writing or electronically. Form A is always used for contracts with an individual who is not an entity, regardless of the contract value. Form B is always used for contracts with an entity when the contract value is less than $50,000. Form C is recommended for contracts valued at $50,000 or more with an entity. If Form C is not used, either Form D or E must be used; both require a resolution (new or prior).
For Use By:
Less Than $50,000
$50,000 or More
- individual: a person who is not an entity
- entity: corporation, limited liability company, or partnership
EXPLANATION OF FORMS
Form A. Representation: For use by an individual when entering into any contract, regardless of contract value.
Form B. Representation: For use by an entity when entering into any contract valued at less than $50,000 for any year of the contract.
Form C. Affidavit: (Recommended for contracts at or above $50,000) For use by an entity when entering into any contract valued at $50,000 or more for any year of the contract and the entity certifies through an affidavit that a complying nondiscrimination policy is currently in place.
Form D. New Resolution: For use by a entity when entering into any contract valued at $50,000 or more for any year of the contract and the entity has a complying nondiscrimination policy adopted by a new resolution of the board of directors, shareholders, managers, members, or other governing body.
Form E. Prior Resolution: For use by a entity when entering into any contract valued at $50,000 or more for any year of the contract and the entity has a complying nondiscrimination policy adopted by a prior resolution of the board of directors, shareholders, managers, members, or other governing body.
Pursuant to Public Act No. 09-158, Section 1(a)(5)(d), the entities listed below are exempt and, therefore, not required to submit a nondiscrimination certification form when entering into a contract with the State:
- political subdivisions of the State of Connecticut, including, but not limited to municipalities;
- quasi-public agencies, as defined in C.G.S. § 1-120;
- other states of the United States, including, but not limited to, the District of Columbia, Puerto Rico, U.S. territories and possessions, and federally recognized Indian tribal governments, as defined in C.G.S. § 1-267;
- the federal government;
- foreign governments; and
- an agency of a subdivision, agency, state or government listed
in items 1-5.
For Further Information, Contact:
Please direct any questions about the nondiscrimination certification forms to the Commission on Human Rights and Opportunities:
Tel. 860/ 541-3400
Connecticut Toll Free Tel. 1-800/ 477-5737
Content Last Modified on 9/30/2011 9:38:35 AM