00 45 41 Small Business Affidavit (1).pdf
PDF 177 KB Posted
- Attached to
- Small Business Bid XF25 Arc Reflection System
- Solicitation number
- 3842
- Issued by
- Knox County, Tennessee
About this file
The document is a Small Business Affidavit for a state and local contract opportunity involving Knox Utilities Board (KUB) for the XF25 Arc Reflection System. This affidavit is designed for small businesses with 50 or fewer employees and annual revenues of $10,000,000 or less, seeking to bid on the project with Control Number 3842. The bidding entity must commit to self-performing a minimum of 51% of the work and fully comply with the owner's small business program requirements.
The affidavit outlines specific qualifications for small business participation, including strict adherence to bid specifications and acknowledgment that any deviation could result in removal from the worksite and termination of the contract. The document requires the bidding entity to verify its small business status through sworn testimony, including details about company size, revenue, and commitment to self-performance. The affidavit must be signed, dated, and notarized, serving as a formal declaration of the company's eligibility and commitment to the small business program requirements for this specific project.
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Other files
| File | Type | Posted |
|---|---|---|
| Bid_Terms_and_Conditions_2.1.23.pdf |
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Text version
[PROJECT NAME]
[PROJECT ID] SMALL BUSINESS AFFIDAVIT
REVISED 05/01/23 00 45 41 - 1
DOCUMENT 00 45 41
SMALL BUSINESS AFFIDAVIT
STATE OF
COUNTY OF
Comes the affiant after having first been duly sworn and testifies as follows:
1. My name is ______________________________. I hold the principal office of
_______________________ for (Name of Principal Office) (Name of Bidding Entity)
2. _____________________________ has submitted a bid to Owner for the construction (Name of Bidding Entity) of the Work entitled: Small Business Bid XF25 Arc Reflection System, Control Number: 3842
3. ______________________________ has fifty (50) or fewer employees and has (Name of Bidding Entity) annual revenue of $10,000,000 or less for the previous calendar year and;
4. ______________________________ verifies that it shall self-perform a minimum of
(Name of Bidding Entity) fifty-one percent (51%) of the work and shall fully comply with all Owner’s small business program requirements and terms and conditions as stated in the bid specifications and;
5. acknowledges that any deviations whatsoever from (Name of Bidding Entity) the requirements stated in the bid shall be just cause for removal of Contractor from worksite and termination of Agreement with cause according to the terms and conditions of the Contract Documents.
[PROJECT NAME]
SMALL BUSINESS AFFIDAVIT [PROJECT ID]
00 45 41 - 2 REVISED 05/01/23
6. This affidavit is made on personal knowledge.
Further the affiant saith not this _______ day of __________________, 20____.
(signature)
(print name)
Title:
NOTARY:
Witnessed before me this _____ day of __________________, 20____.
My Commission Expires:
STAMP
File details come from the government source that posted it. Updated .