00 45 41 Small Business Affidavit (1).pdf
PDF 177 KB Posted
- Attached to
- Small Business Bid Chemtrac Instrumentation
- Solicitation number
- 3850
- Issued by
- Knox County, Tennessee
About this file
This document is a Small Business Affidavit for a Chemtrac Instrumentation bid (Control Number: 3842) being processed by KUB (Knoxville Utilities Board) in Tennessee. The bid is for the Small Business Bid XF25 Arc Reflection System, with specific requirements that the bidding entity must have 50 or fewer employees, annual revenue of $10,000,000 or less for the previous calendar year, and commit to self-performing a minimum of 51% of the work. The bid requires delivery of all items by May 19th, 2025, and vendors must be a Chemtrac brand with matching part numbers.
The affidavit outlines strict compliance requirements for small business vendors, including a clear warning that any deviation from bid specifications will result in removal from the worksite and termination of the agreement. The document serves as a formal declaration by the bidding entity that they meet the small business program requirements, with provisions for verification and potential disqualification. Vendors must complete the affidavit, have it notarized, and submit it as part of their bid package to be considered for the contract opportunity.
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Other files
| File | Type | Posted |
|---|---|---|
| Bid_Terms_and_Conditions_2.1.23.pdf | ||
| 3850_Invitation Letter.pdf |
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Text version
Chemtrac Instrumentation #3850
#3850 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 #3850
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 __________________, 2025.
My Commission Expires:
STAMP
File details come from the government source that posted it. Updated .