Contract Forms, Documents and Provisions

All contracts with the University require certain State of Connecticut affidavits, certifications and provisions (language).

The deletion or revision of required State contract provisions require approval by the Office of the Attorney General.  These provisions are required terms regardless of type, term, cost or value (including income generating contracts). Any revisions [after the contract is finalized] must be initialed by both parties at time of execution.

Supporting documents listed below (and also to the right) are also required. The maximum value of the contract determines which supplemental affidavits or certifications are needed for execution of the contract.


I. Required Documents for all Contracts Regardless of Value

A. State Nondiscrimination Certification

      1. This Certification should signed by the individual who executes the contract
      2. This document must be signed and dated the same day as the contract.
      3. Find the forms and additional guidance at the State OPM website:

For Contracts with a Value of Less Than $50,000 use:

        • Form A:  Representation By Individual
        • Form B: Representation By Entity

For Contracts with a Value of $50,000 or More use:

        • Form A:  Representation By Individual
        • Form C:  Affidavit By Entity
        • Form D:  New Resolution By Entity
        • Form E:  Prior Resolution By Entity


 II.  Documents Required for Contracts Valued at $50,000 and Greater

 Please include documents from section I. above.

A.  State Ethics Form 1 – Gift and Campaign Contribution Certification.
      1. Must be signed by the individual who executes the contract
      2. This document must be signed and dated the same day as the contract.
      3. Be sure to complete both pages 1 and 2, and do not leave the lines on page 2 blank – if no contributions were made, insert “None” on a blank.


B.  State Ethics Form 5 – Consulting Agreement Affidavit
      1. Must be signed by the individual who executes the contract
      2. This document must be signed and dated the same day as the contract.
      3. Complete only the shaded area at the bottom of the form, unless the company did enter into a consulting agreement regarding this contract with UConn.


C.  State Ethics Form 3 – Certification of State Agency Official or Employee Authorized to Execute Contract      
      1. Must be signed by the University Signatory who executes the contract, on same date it is executed by UConn.

Forms and additional guidance may be found at OPM ethics forms:


III.  Documents Required for Contracts Costing UConn $500,000 or more

Please include documents from sections I. and II. above.

A. State Ethics Form 7 – Iran Certification               
      1. Form 7 must always be submitted with the resulting contract, regardless of where the principal place of business is located.
      2. Complete “Respondent Name” at the top part of this form with contractor name.
      3. Please read this form carefully, if your company’s principal place of business is located within the United States you may leave the rest of the form blank.
      4. Part C. “Certification requirements,” is completed ONLY if the contractor’s principal place of business is located outside of the United States (a contractor is any corporation, general partnership, limited partnership, limited liability partnership, joint venture, nonprofit organization or other business organization). For purposes of this form, a “foreign corporation” is one that is organized and incorporated outside the United States of America. United States subsidiaries of foreign corporations are exempt.
B. State Ethics Form 6 Affirmation of Receipt of State Ethics Laws
      1. Form 6 is used ONLY for large State construction contracts or large State procurement contracts.


 IV. Signatory Authority Certifications

Only Required for contracts involving transactions that must be recorded on the land records. 

  1. Please contact the Office of the General Counsel if you think you require one of the forms below.
  2. This document indicates that that the person who executes the contract has authority to sign on behalf of the company. Please note that an individual cannot authorize themselves to sign on behalf of a company/organization unless they are the sole owner. The authority must be signed by an officer of the company if owned by more than one person/entity.
  3. This document must be signed and dated the same day as the contract but adopted Prior To the signing of the contract
    1.  Corporations should use forms #1, #2, or #3. Corporations often establish signatory by bylaw or other document (i.e. a resolution by the BOD), a copy of that document must accompany the Certification.

Form 1 – CORPORATION – Certification – By Sole Owner [Corporation, Professional Corporation or Non-Profit Assoc./Org. ]

Form 2 – CORPORATION (Including Non-Profit Assoc./Org.) – Certification of Bylaws – By Corporate Officer

Form 3 – CORPORATION (Including Non-Profit Assoc./Org.) – Certified Resolution – By Corporate Officer


b.  Limited Liability Company (LLC) should use either sample form #4 or #5.

–  Be sure to identify the signatory of an LLC as a member or manager.

Form 4 – LIMITED LIABILITY COMPANY (LLC) – Sole Member/Manager Certification

Form 5 – LIMITED LIABILITY COMPANY (LLC) – Certification


c.  Partnership should use the “Partnership” form #6.

Form 6 – PARTNERSHIP – Certificate Of Authority


d.  “Opinion of Legal Counsel” (form #7), should be used if your organization’s formation is complicated.

Form 7 – COMPANY or ORGANIZATION – Opinion Of Legal Counsel