INSTRUCTIONS: This Standard Form 275 is to be used in cases where it is desired to cover the excess of a Direct Writing Company's underwriting limitation by reinsurance instead of coinsurance on bonds running to the United States except Miller Act Performance and Payment Bonds. See 41 CFR 1-10.202 and 1-16.801. If this form is used to reinsure a bid bond, the "Penal Sum of Bond" and "Amount of this Reinsurance" may be expressed as a percentage of the bid provided the actual amounts will not exceed the companies' respective underwriting limitations. This form should be executed and filed as follows: Original and copies as specified by the bond-approving officer, signed and sealed, shall be filed with the bond or within the time period set forth in the bid or proposal. One carbon copy, signed and sealed, shall accompany the Direct Writing Company's quarterly Schedule of Excess Risks filed with the Department of the Treasury. Other copies may be prepared for the use of the Direct Writing Company and the Reinsuring Company. A separate form should be used for each Reinsuring Company. [42 FR 56119, Oct. 21, 1977] :: US. GOVERNMENT PRINTING OFFICE 1977-0-240-463 104 STANDARD FORM 275 BACK (8-77) § 1-16.901-279 FPDS-Individual Action Report (over $10,000). 13-132 0-83--19 STANDARD FORM 279 (REV. 10-82) ITEM PURCHASED FOR EXCLUSIVE USE OF THE US. GOVERNMENT (Describe) § 1-16.901-1094 Standard Form 1094, U.S. Tax Exemption Certificate. I certify that the information on this form is true and correct to the best of my knowledge and belief. A tax exemption certificate OF CONTRACTWO. SPECIME IDATE STANDARD FORM 1094 (REV. 4-80) INSTRUCTIONS 1. This form will be used to establish the Government's ex- 2. This form shall NOT be used for: (a) Purchases of quarters or subsistence made by employ. ees in travel status. (b) Expenses incident to use of a privately owned motor vehicle for which a mileage allowance has been authorized, or (c) Merchandise purchased which is subject only to Federal Tax. 3. If the spaces provided on the face of this form are inade- 4. If both State and Local taxes are involved, use a separate form for each tax. The certificate will be provided to the vendor when the prices exclude State or Local tax. 5. The serial number of each certificate prepared will be shown on the payment voucher. THE FRAUDULENT USE OF THIS CERTIFICATE FOR THE PURPOSE OF OBTAINING EXEMPTION FROM OR ADJUST- [46 FR 17562, Mar. 19, 1981] STANDARD FORM 1094 BACK (REV. 4-80) Record. § 1-16.901-1094-A Standard Form 1094 -A U.S. Tax Exemption Certificates Accountability To be used for convenience of the issuing agency for maintaining a control record of tax exemption certifi. cates issued. ISSUED TO THROUGH TITLE AND OFFICE DESIGNATION TAX EXEMPTION CERTIFICATES RETURNED UNUSED FOR REISSUE REISSUED TO SPECIMEN OFFICE DESIGNATION SIGNATURE THROUGH DATE ISSUED ISSUING TITLE AND OFFICE DESIGNATION DATE ISSUED SPECIMEN VENDOR NAME AND ADDRESS St nor TRANSACTION REFERENCE $ PO/Cont. No. VENDOR NAME AND ADDRESS ITEM PURCHASED STANDARD FORM 1094-A BACK (REV. 4-80) |