Arizona Department of Revenue Prime Contractor’s Certifi cate

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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This Form Superseded All Other Form 5005’s

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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