West Virginia Code § 5A-3-12

Prequalification disclosure and payment of annual fee by vendors
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required; form and contents; register of vendors; false certificates; penalties.
(a) The director may not accept any bid received from any vendor unless the vendor has paid
the annual fee specified in §5A-3-4 of this code and has filed with the director a certificate of
the vendor or the certificate of a member of the vendor's firm or, if the vendor is a
corporation, the certificate of an officer, director or managing agent of the ceorporation,
disclosing the following information:
(1) If the vendor is an individual, his or her name and city and state of residence and
business address, and, if he or she has associates or partners shauring in his business, their
names and city and state of residence and business addresses;
(2) If the vendor is a firm, the name and city and state of residence and business address of
the firm;
(3) If the vendor is a corporation created under thel laws of this state or authorized to do
business in this state, the name and business saddress of the corporation;
(4) A statement of whether the vendor is aicting as agent for some other individual, firm or
corporation, and if so, a statement of the principal authorizing the representation shall be
attached to the certificate or whether the vendor is doing business as another entity;
(5) The vendor's latest Dun & Bradstreet number and rating, if there is any rating as to the
vendor; and
(6) The vendor's tax identification number.
(b) Whenever a change occurs in the information submitted as required, the change shall be
reported immediately in the same manner as required in the original disclosure certificate.
(c) WThe certificate and information received by the director shall be public record.
(d) The director may waive the above requirements in the case of any corporation listed on
any nationally recognized stock exchange and in the case of any vendor who or which is the
sole source for the commodity in question.
(e) Any person who submits a false certificate or who knowingly files or causes to be filed
with the director, a certificate containing a false statement of a material fact or omitting any
material fact, is guilty of a misdemeanor and, upon conviction, shall be fined not more than
$1,000, and, in the discretion of the court, confined in jail not more than one year. An
individual convicted of a misdemeanor under this subsection may never hold an office of
honor, trust or profit in this state, or serve as a juror.

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