Arizona Department of Revenue
Prime Contractor’s Certifi cate
ADOR 60-2015 (4/02)
The purpose of this form is to provide a subcontractor with the validation required for tax exemption of a particular project, for a period of time, or until
revoked. This certifi cate establishes responsibility for the transaction privilege tax; therefore, it must be completed by the prime contractor assuming
the contracting transaction privilege tax liability for the contracting project(s). The asterisked (*) items must be completed, otherwise the certifi cate
is not valid. The Department may disregard this certifi cate pursuant to ARS § 42-5075.E if the certifi cate is incomplete or erroneous. If disregarded,
the entity accepting the certifi cate (subcontractor) will have the burden of proving (pursuant to ARS § 42-5075.D), that it is not subject to transaction
privilege tax as a taxable prime contractor.
ARIZONA FORM
5005
A. Prime Contractor
* NAME:
* ADDRESS:
* TRANSACTION PRIVILEGE LICENSE #:
AZ Contractor License #:
Telephone #:
B. Subcontractor
* NAME:
* ADDRESS:
* TRANSACTION PRIVILEGE LICENSE #:
AZ Contractor License #:
Telephone #:
C. Type of Certifi cate (check one and provide requested information)
Single Project Certifi cate
PROJECT DESCRIPTION
OR
** (For example; Building Permit #, Address,
Subdivision, Book/Map/Parcel #s,
and/or Legal Description)
Blanket Certifi cate (check applicable box and fi ll in requested
information).
Period From:
Through:
Until revoked
Specifi c Exceptions:
I hereby certify that I have authority to sign this Certifi cate on behalf of Prime Contractor. I understand that by excuting this Certifi cate, Prime
Contractor is assuming the prime contracting transaction privilege tax liability applicable to the above referenced project(s).
SIGNATURE
PRINT NAME
TITLE
DATE SIGNED
This Form Superseded All Other Form 5005’s
ADOR 60-2015 (4/02)
PURPOSE
Arizona statutes impose transaction privilege tax on entities
engaged in the business of prime contracting. If an entity
meets the defi nition of the term “contractor” on a given project,
that entity is liable for transaction privilege tax as a prime
contractor or has the burden of proving that it is not the prime
contractor for that contracting project. Obtaining a completed
Arizona Department of Revenue Prime Contractor’s Certifi cate
satisfi es that burden of proof. However, the Department of
Revenue has the discretion to disregard the Certifi cate if it is
incomplete or erroneous.
GENERAL INSTRUCTIONS
In order to ensure the effectiveness of the Certifi cate, all
required fi elds must be completed.
A. The “NAME”, “ADDRESS”, and TRANSACTION
PRIVILEGE LICENSE #” fi elds of the Prime Contractor
section must be completed. The prime contractor
is the entity responsible for the tax.
B. The “NAME”, and “ADDRESS”, fi
elds of the
Subcontractor section must be complete.
C. Either the “Single Project Certifi cate” box or the “Blanket
Certifi cate” box of the Type of Certifi cate section must be
checked.
If the Single Project Certifi cate box is checked, the
“PROJECT DESCRIPTION” must be supplied. The
project description must be suffi cient to identify the
location of the single project or the Certifi cate will be
deemed incomplete by the Department of Revenue.
If the Blanket Certifi cate box is checked, either the
“From: Through:” box or the “Until revoked” box
must be checked. If the “From: Through:” box is
checked, the “From: Through:” dates must be
provided.
The
“Specifi c Exceptions” box is optional
and allows the “Prime Contractor” to exclude Specifi c
projects or time periods from the Blanket Certifi cate.
If
the
“Specifi c Exceptions” is checked, details
describing the excluded project(s) or the excluded
time periods must be provided.
The “SIGNATURE” “TITLE”, “PRINT NAME” and
“DATE SIGNED” FIELDS of the Signature section
must
be
completed.
Failure to complete these fi elds as specifi ed may result in the
Arizona Department of Revenue disregarding the incomplete
Certifi cate.
RETROACTIVE EFFECT
If a Certifi cate is signed subsequent to the commencement or
completion of a contracting project intended to be within the
scope of the Certifi cate, the Department of Revenue will give
retroactive effect to the Certifi cate for the intended project.
However, the Certifi cate will only be given retroactive effect for
periods within 4 years of the execution date of the Certifi cate.
In the event that the “Blanket Certifi cate” box is checked and
the “Until revoked” option is selected thereunder, in order to
give a Certifi cate retroactive effect, the “Prime Contractor”
must indicate, next to the “Until revoked” box, the effective
date of the Blanket Certifi cate.
ASSUMPTION OF LIABILITY
In most instances, the entity assuming the prime contracting
transaction privilege tax liability for the contracting project(s)
referenced in the Certifi cate will legally be the prime contractor
for such project(s). However, in some instances such entity
may not legally be the prime contractor for such project(s).
If an entity is NOT LEGALLY the prime contractor for such
project(s), the Certifi cate will nevertheless be effective and
will subject such entity to the transaction privilege tax liability
of the entity shown as the “Subcontractor” on the Certifi cate if
such “Subcontractor” IS LEGALLY the prime contractor.
Prime Contractor’s Certifi cate Instructions