04-Affirmation and Disclosure Form_3-4-22.pdf
PDF 80 KB Posted
- Attached to
- 6 Polaris Ranger Crew XP 1000 UTVs
- Solicitation number
- SRC0000021530
- Issued by
- Ross County, Ohio
About this file
The document is an Affirmation and Disclosure Form required for a state and local contract opportunity issued by the Ohio Division of Forestry. The contract is for the purchase of 6 Polaris Ranger Crew XP 1000 UTVs, with specific accessories and features. The UTVs must be new 2024 or 2025 models, and the contract requires the successful bidder to provide the location(s) where the services will be performed and where the state data will be stored. The UTVs are to be delivered to the Scioto Trail State Forest in Chillicothe, Ohio. The contract is open to all qualified bidders, and the Ohio Division of Forestry is exempt from Ohio state sales tax.
The pricing for the UTVs and accessories must be itemized, and the bidder may offer a lesser quantity if they cannot provide all 6 UTVs as requested. The contract includes manufacturer warranties and guarantees that must be transferred to the Ohio Division of Forestry. There are no set-asides or incumbent information provided, and the funding source and requirements are not specified in the document.
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Other files
| File | Type | Posted |
|---|---|---|
| Standard_T_C_04-10-23.pdf | ||
| UTV Requsition 2024 grant funded qty 6.pdf |
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Text version
AFFIRMATION AND DISCLOSURE FORM
Rev. 3/22 Page 1 of 2
Contractor affirms that Contractor has read and understands the applicable Executive Orders regarding the prohibitions of performance of offshore services, locating State data offshore in any way, or purchasing from Russian institutions or companies.
Contractor shall provide all the name(s) and location(s) where services under this Contract will be performed and where data is located in the spaces provided below or by attachment. Failure to provide this information may result in no award. If the Contractor will not be using subcontractors, indicate “Not
Applicable” in the appropriate spaces.
1. Principal location of business of Contractor:
(Address) (City, State, Zip)
Name/Principal location of business of subcontractor(s):
(Name) (Address, City, State, Zip)
2. Location where services will be performed by Contractor:
Name/Location where services will be performed by subcontractor(s):
Rev. 3/22 Page 2 of 2
3. Location where state data will be located, by Contractor:
Name/Location(s) where state data will be located by subcontractor(s):
Contractor affirms, understands, and agrees that Contractor and its subcontractors are under a duty to disclose to the State any change or shift in location of services performed by Contractor or its subcontractors before, during and after execution of any contract with the State. Contractor agrees it shall so notify the
State immediately of any such change or shift in location of its services. The State has the right to immediately terminate the contract, unless a duly signed waiver from the State has been attained to perform the services outside the United States.
On behalf of the Contractor, I acknowledge that I am duly authorized to execute this Affirmation and
Disclosure Form and have read and understand that this form is a part of any Contract that Contractor may enter into with the State and is incorporated therein.
By:
Contractor
Print Name:
Title:
Date:
File details come from the government source that posted it. Updated .