PUBLIC HOUSING NOTICE NO 2007-02
Memorandum
To: Executive Director, Local Housing Authority
From: Gay Eng, Capital Finance Manager
Bureau of Housing Development and Construction
Division of Public Housing and Rental Assistance
Subject: Executive Order 481 – Contractor Certification Form
Date: March 26, 2006
Effective as of February 23, 2007, all contracts signed with our agency must be
accompanied by a certification form indicating compliance with Executive Order
481, which prohibits contractors (LHAs) receiving funds under state contracts
from using undocumented workers. The attached Certification Form should be
completed by the authorized contract signatory (LHA Chairperson) at your local
housing authority and returned to our office by Friday, April 6, 2007.
Please send the original signed form to Colleen Votour, 100 Cambridge Street,
Suite 300, Boston, MA 02114. It is imperative that this form be returned
immediately as this affects the encumbrance of new Contracts for Financial
Assistance (CFA) and CFA amendments, including changes to your dates of service.
If you have any questions regarding this matter, you may call me at
617-573-1194.
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE ORDER 481 - CONTRACTOR CERTIFICATION
PROHIBITING THE USE OF UNDOCUMENTED WORKERS ON STATE CONTRACTS
CONTRACTOR LEGAL NAME:
CONTRACTOR VENDOR/CUSTOMER CODE:
Issued March 2007
INSTRUCTIONS:
Executive Order 481 applies to all state agencies in the Executive Branch,
including all executive offices, boards, commissions, agencies, departments,
divisions, councils, bureaus, and offices, now existing and hereafter
established. As it is the policy of the Executive Branch to prohibit the
use of undocumented workers in connection with the performance of state
contracts, all contracts entered into after February 23, 2007 require that
contractors, as a condition of receiving Commonwealth funds under any Executive
Branch contract, make the following certification:
CONTRACTOR CERTIFICATION:
As evidenced by the signature of the Contractor’s Authorized Signatory below,
the Contractor certifies under the pains and penalties of perjury that the
Contractor shall not knowingly use undocumented workers in connection with the
performance of all Executive Branch contracts; that pursuant to federal
requirements, the Contractor shall verify the immigration status of all workers
assigned to such contracts without engaging in unlawful discrimination; and that
the Contractor shall not knowingly or recklessly alter, falsify, or accept
altered or falsified documents from any such worker(s). The Contractor
understands and agrees that breach of any of these terms during the period of
each contract may be regarded as a material breach, subjecting the Contractor to
sanctions, including but not limited to monetary penalties, withholding of
payments, contract suspension or termination.
_____________________________________________
Date:____________________
Contractor Authorizing Signature
_____________________________________________
Print Name
Title:_____________________________________________
Telephone_____________________________________________
Fax:_____________________________________________
Email:_____________________________________________
The Contractor is required to sign this Certification only once and may provide
a copy of the signed Certification for any contract executed with an Executive
Branch Department. A copy of this signed Certification must be attached to
the “record copy” of all contracts with this Contractor that are filed with the
contracting Department