Arizona Department of Revenue

                    Arizona Form                                   Contractor’s Certificate 
                    5005                                           Prime Contracting and MRRA
The purpose of this Certificate is to provide a subcontractor with the validation required for prime contracting transaction privilege tax (TPT) 
exemption, and for exemption from liability for an amount equal to retail TPT on materials incorporated or fabricated into maintenance, repair, 
replacement or alteration (MRRA) projects. The Certificate can be provided for a particular project, for a period of time, or until revoked.  This 
Certificate establishes liability of the contractor issuing it for the prime contracting TPT and/or the amount equal to the retail TPT; therefore, 
it must be completed by the contractor assuming the liability.  The asterisked (*) items must be completed; otherwise, the Certificate is not 
valid.  The Department may disregard this Certificate pursuant to A.R.S. § 42-5008.01 or A.R.S. § 42-5075.E if the Certificate is incomplete 
or erroneous.  If disregarded, the subcontractor accepting the Certificate will have the burden of proving (pursuant to A.R.S. § 42-5008.01 or  
A.R.S. § 42-5075.D), that it is not liable for the prime contracting TPT and/or the amount equal to the retail TPT.
  Prime contractor should provide this Certificate to the subcontractor(s) and retain a copy for their records.
A. Contractor
* Name                                                             *   TPT License    Tribal Business License    Tribal Number

* Address                                                          City, Town or Post Office           State         ZIP Code

AZ Contractor License Number                                       Phone Number

 I am a Native American Contractor working on the reservation established for my tribe. (Provide your Tribal Business License or Tribal Number above.)
I am performing contracting work for a  Native American member or  the Tribe for which the reservation is established named below.
Name of Tribe

B. Subcontractor
* Name                                                             * TPT License # (if none, write “N/A - MRRA only”)

* Address                                                          City, Town or Post Office           State         ZIP Code

AZ Contractor License Number                                       Phone Number

C*. Type of Certificate (check one and provide requested information)
 Single Project Certificate                                            Blanket Certificate (check applicable box and fill in requested 
 *PROJECT DESCRIPTION                                                    information).*
  * (For example; Building Permit #, Address, Subdivision,    OR          Period From:                    Through: 
      Book/Map/Parcel #s, and/or Legal Description)
                                                                          Until revoked
                                                                         * NOTE:  Blanket Certificate indicates the prime contractor is responsible 
                                                                         for every contract during the period regardless of contract designation.
                                                                          Specific Project Exclusion: 
 Project Designation (see instructions for definitions)
  MRRA
  Modification                                                            Description:  
                                                                          Designation:    MRRA      Modification

I hereby certify that I am the contractor issuing this form or I have authority to sign this Certificate on behalf of Contractor.  I understand 
that by executing this Certificate, Contractor is licensed for TPT purposes and is assuming the prime contracting TPT liability 
and/or the amount equal to retail TPT liability applicable to the above referenced project(s).

SIGNATURE                                                              PRINT NAME

TITLE  DATE SIGNED

ADOR 10313  (5/21)  This Form Superseded All Other Form 5005’s
                                                                   Print                  Reset

                              Contractor’s Certificate Instructions

  GENERAL INSTRUCTIONS                                                 
                                                                        Component:  One of the parts of a compound or  
In order to ensure the effectiveness of the Certificate, all required    complex whole; helping to make up the whole of  
fields must be completed.                                                something.  A component may be part of a system.
A.  The “NAME”, “ADDRESS”, and “TPT LICENSE NUMBER”                     System:  A regularly interacting or interdependent   
  fields of the Contractor section must be completed.                    group of items (or components) forming a unified whole.
 The contractor is the entity responsible for the tax.
                                                                        Tangible personal property installed in existing         
 A contractor who is Native American, working on the                    property:   Property installed into existing real property  
 reservation established for their tribe will mark the box               that can still be identified after installation, that does not   
 indicating this.                                                        lose its character and can be removed in essentially the   
                                                                         same form.
 A contractor working for the Native American or the Tribe 
 on the reservation established for the Tribe will mark the box        Alteration:  An activity or action that causes a direct  
 indicating this.  The name of the Tribe must also be included.        physical change (e.g., adding or expanding square footage)    
                                                                        to existing property that cannot be classified as 
B.  The “NAME”, “ADDRESS”, and “TPT LICENSE” fields of the             maintenance, repair or replacement and that is under the 
 Subcontractor section must be complete.                                following thresholds. For residential property (see  
                                                                       explanation below) the alteration amount is less than 25%  
C. Either the “Single Project Certificate” box or the “Blanket         of the property’s value as determined by the county  
 Certificate” box of the Type of Certificate section must be            assessor. For commercial property (see explanation  
 checked.                                                              below), the alteration amount is for less than $750,000.  
  If the “Single Project Certificate” box is checked, the             If the above thresholds are exceeded, then the project is a  
  “PROJECT DESCRIPTION” must be supplied.  The                         modification project (see below).
  project description must be sufficient to identify the               Modification:  Activities encompassing “ground up”  
   location of the single project or the Certificate will be           construction, grading and leveling ground, and wreckage   
   deemed incomplete by the Department.                                or demolition, or other new contracting activity where none  
  Additionally, if the “Single Project Certificate” box is             previously existed to the extent such activity cannot  
  checked, a project designation description must be                    otherwise be characterized as maintenance, repair,  
   provided.  See below for definitions.                               replacement or alteration (“MRRA”).
  If the “Blanket Certificate” box is checked, either the             Residential:  Existing property classified as class 
   “From: Through:” box or the “Until revoked” box                     two property and that is used for residential purposes 
  must be checked.  If the “From: Through:” box is                      (see A.R.S. § 42-12002(1)(c)); class three property 
   checked, the “From: Through:” dates must be                         (see  A.R.S.  § 42-12003), or class four property  
   provided.  The “Specific Project Exclusion” box is optional         (see A.R.S. § 42-12004).
   and allows the “Prime Contractor” to exclude specific               Commercial:  All other existing property not classified as 
  projects or time periods from the Blanket Certificate.                residential (classes one, five, six, seven, eight, and 
   If the “Specific Project Exclusion” box is checked, details         nine).  See  A.R.S.  §§ 42-12001, 42-12005, 42-12006, 
   including the project’s description and designation or the          42-12007, 42-12008, and 42-12009.
   excluded time periods must be provided.
  The “SIGNATURE”, “TITLE”, “PRINT NAME” and                           RETROACTIVE EFFECT
   “DATE SIGNED” FIELDS of the Signature section                      If a Certificate is not signed contemporaneously with the 
   must be completed.                                                 commencement of a contracting project intended to be within the 
Failure to complete these fields as specified may result in           scope of the Certificate, the Department will accept the Certificate 
the Department disregarding the incomplete Certificate.               as evidence of the alleged facts.  However, the person receiving 
                                                                      the Certificate may not receive the benefit of the Certificate if 
                                                                      the Department determines that any of the facts set forth in the 
  MRRA AND MODIFICATION DEFINITIONS                                   Certificate are inaccurate.
 Maintenance:  The upkeep of property or equipment.                     ASSUMPTION OF TPT LIABILITY
 Repair:  Returning existing property to a usable state from          In most instances, the entity assuming the transaction 
 a partial or total state of inoperability or non-functionality.      privilege tax liability for the contracting project(s) referenced 
                                                                      in the Certificate will legally be the prime contractor 
 Replacement:  Removal from service of existing property              for such project(s).  However, in some instances such 
 of a: (i) component; or (ii) system; or (iii) type of tangible       entity may not legally be the prime contractor for such  
 personal property, and replacement with another one that             project(s).  If an entity is not the prime contractor for such 
 provides the: (i) same; or (ii) similar; or (iii) upgraded design    project(s), the Certificate will nevertheless be effective and will 
  or functionality; regardless of whether the existing                subject such entity to the transaction privilege tax liability of the 
  component or system or existing tangible personal                   entity receiving the Certificate.
 property is physically removed from the existing property.

ADOR 10313  (5/21)  This Form Superseded All Other Form 5005’s