Form AC3277-S "Contract Certification Form for Quick Contract Processing" - New York

What Is Form AC3277-S?

This is a legal form that was released by the Office of the New York State Comptroller - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2019;
  • The latest edition provided by the Office of the New York State Comptroller;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AC3277-S by clicking the link below or browse more documents and templates provided by the Office of the New York State Comptroller.

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Download Form AC3277-S "Contract Certification Form for Quick Contract Processing" - New York

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AC 3277-S (Revised 7-19) Page 1of 2
OFFICE OF THE STATE COMPTROLLER
CONTRACT CERTIFICATION FORM
FOR QUICK CONTRACT PROCESSING
Type of Contract:
Service
Printing
Commodity
Technology
Equipment
Business Unit # / Name:
Department ID / Name:
Contractor Name:
Contract Number:
Contract Amount:
Certification:
I, ___________________________________ , a ____________________________________
Agency Officer
Title
for _______________________________________ , have reviewed this contract entered into
Agency Name
on ___________________________ .
Date
and under penalty of perjury certify to the following:
1. The contract information listed above is correct.
2. The Procurement Record Checklist is attached to this package (if required by the
Procurement Guidelines) and is fully completed, including a Statement of Need.
3. The IFB specifications were written to solicit competition, and not with the intention of
directing an award to a particular vendor.
4. The IFB included a clearly stated Method of Award, and: (i) three or more responsive bids
were received; (ii) award was made to the lowest responsible bidder in accordance with
the stated Method of Award; (iii) no bidder, who otherwise would have been a low bidder,
was disqualified; (iv) no bid, that would otherwise have been a low bid, was rejected; (v)
no bid which would otherwise been a low bid was withdrawn; (vi) a copy of the agency’s
certified bid tabulation and all other required documentation, including all original bids, is
attached.
5. Where applicable, the requirements of New York State Finance Law, Section 162, and the
Preferred Source Guidelines were complied with, and the preferred source has been
advised and has not objected to the agency’s decision.
6. The procurement opportunity was advertised, where required, in the New York State
Contract Reporter and a copy of that advertisement is attached.
7. The award of this procurement was based upon a formal competitive bid, and conforms to
all State and other applicable law, rules, regulations, and established policies.
AC 3277-S (Revised 7-19) Page 1of 2
OFFICE OF THE STATE COMPTROLLER
CONTRACT CERTIFICATION FORM
FOR QUICK CONTRACT PROCESSING
Type of Contract:
Service
Printing
Commodity
Technology
Equipment
Business Unit # / Name:
Department ID / Name:
Contractor Name:
Contract Number:
Contract Amount:
Certification:
I, ___________________________________ , a ____________________________________
Agency Officer
Title
for _______________________________________ , have reviewed this contract entered into
Agency Name
on ___________________________ .
Date
and under penalty of perjury certify to the following:
1. The contract information listed above is correct.
2. The Procurement Record Checklist is attached to this package (if required by the
Procurement Guidelines) and is fully completed, including a Statement of Need.
3. The IFB specifications were written to solicit competition, and not with the intention of
directing an award to a particular vendor.
4. The IFB included a clearly stated Method of Award, and: (i) three or more responsive bids
were received; (ii) award was made to the lowest responsible bidder in accordance with
the stated Method of Award; (iii) no bidder, who otherwise would have been a low bidder,
was disqualified; (iv) no bid, that would otherwise have been a low bid, was rejected; (v)
no bid which would otherwise been a low bid was withdrawn; (vi) a copy of the agency’s
certified bid tabulation and all other required documentation, including all original bids, is
attached.
5. Where applicable, the requirements of New York State Finance Law, Section 162, and the
Preferred Source Guidelines were complied with, and the preferred source has been
advised and has not objected to the agency’s decision.
6. The procurement opportunity was advertised, where required, in the New York State
Contract Reporter and a copy of that advertisement is attached.
7. The award of this procurement was based upon a formal competitive bid, and conforms to
all State and other applicable law, rules, regulations, and established policies.
AC 3277-S (Revised 7-19) Page 2 of 2
8. The IFB contains all the necessary and required clauses (i.e., Appendix A, non-collusive
bidding certification, MacBride certification, and M/WBE participation goals).
9. The bid and contract have been properly executed and signed by the appropriate parties.
10. Where applicable, all required bonds, insurances, and other documents have been, or will
be, submitted to the agency named above prior to commencement of the contract.
11. The debriefing period has passed and that all debriefings requested have been completed.
12. No known or written protest or other objection, known to the certifier upon duly diligent
research with respect to award of this purchase order/contract, has been filed with the
procuring agency.
13. All information provided with respect to Chapter 1 of the Laws of 2005 regarding
Procurement lobbying requirements is complete, true, and accurate. All Chapter 1
requirements have been met and the appropriate documentation is attached.
14. If procuring equipment or services, the boilerplate agreement being used is an:
OSC Boilerplate
OSC Approved Agency Boilerplate
15. The certifier named below is authorized to sign contracts on behalf of the
agency/authority.
___________________________________
Certifier Signature
___________________________________
Title
___________________________________
Date
Page of 2