AFFIDAVIT_OF_COMPLIANCE_-_DISADVANTAGED_BUSINESS_ENTERPRISE.pdf
PDF 608 KB Posted
- Attached to
- On-Call Electrician Services
- Solicitation number
- 2026-01
- Issued by
- Fayette County, Kentucky
About this file
Affidavit of Compliance - Disadvantaged Business Enterprise
This document is a certification form for the Transit Authority of Lexington-Fayette Urban County Government (Lextran) in Kentucky related to the On-Call Electrician Services procurement (Reference Number 2026-01). The affidavit is designed specifically for proposers or subcontractors who are Disadvantaged Business Enterprises (DBEs) seeking to participate in this competitive contract opportunity. The form requires completion by authorized representatives of DBE firms and must be notarized to verify the company's DBE status as defined by Lextran's specifications. Proposals for the on-call electrician services contract are due by 2:00 pm Eastern Time on Thursday, April 23, 2026, with submission required through Lextran's eProcurement Portal. Questions regarding the procurement must be submitted by end of day Thursday, March 26, 2026. The affidavit itself does not specify contract term, renewal options, or site visit requirements, as it serves solely as a compliance certification mechanism.
The affidavit does not contain pricing information, specific set-aside percentages, or funding details. Rather, it functions as a declarative document under penalty of perjury wherein authorized representatives affirm their company's DBE status and commit to providing documentation requested by Lextran to substantiate that classification. The document requires standard notarization and includes signature lines for both the authorized company representative and the notary public. This certification form is a prerequisite compliance document for DBE firms or DBE subcontractors bidding on Lextran's on-call electrician services contract and does not independently establish contract terms, pricing, or award criteria.
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Text version
AFFIDAVIT OF COMPLIANCE - DISADVANTAGED BUSINESS ENTERPRISE
To be filled out only by proposers that are Disadvantaged Business Enterprise (DBE) or subcontractors who are DBE.
State of ____________________________
County of __________________________
I hereby declare and affirm, that I am the _____________________________________________ (Title)
And duly authorized representative of ________________________________________________ (Company Name)
Company address: ___________________________________________________________________
I hereby declare and affirm that I am a Disadvantaged Business Enterprise (DBE) as defined by the specifications and that I will provide information requested by Lextran to document this fact.
I do solemnly declare and affirm, under the penalties of perjury, that the contents of the aforementioned document are true and correct and that I am authorized, on behalf of the above firm, to execute this affidavit.
DATE: ___________________________________________________________
AUTHORIZED SIGNATURE: _______________________________________
PRINT NAME: ___________________________________________________
Sworn to before me and subscribed in the presence this ______ day of __________________, 20_____.
Notary Public Name: ______________________________________________________
Notary Public Signature: ___________________________________________________
My Commission Expires: ____________________________________
| Company address: |
| I hereby declare and affirm that I am the: |
| And duly authorized representative of: |
| undefined: |
| PRINT NAME: |
| Sworn to before me and subscribed in the presence this: |
| day of: |
| 20: |
| Notary Public Name: |
| Signature1_es_:signer:signature: |
| Signature2_es_:signer:signature: |
| Text3: |
| Text4: |
| Date5_es_:signer:date: |
| Date6_es_:signer:date: |
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