AFFIDAVIT_OF_COMPLIANCE_-_DISADVANTAGED_BUSINESS_ENTERPRISE.pdf
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- Attached to
- Landscaping Services
- Solicitation number
- 2026-03
- Issued by
- Fayette County, Kentucky
About this file
This is an Affidavit of Compliance form for Disadvantaged Business Enterprise (DBE) designation, created for the Transit Authority of Lexington-Fayette Urban County Government (Lextran) in Kentucky in connection with a landscaping services contract opportunity. The form is to be completed solely by proposers or subcontractors who qualify as a DBE and wish to document their eligibility status. The affidavit requires the authorized representative of the DBE firm to declare under penalty of perjury that the company meets the specifications and definition of a DBE as established by Lextran, and that the firm will provide supporting documentation upon request to verify this classification. The document must be notarized, with signatures from both the authorized company representative and a notary public, along with the company's name, address, title of the authorized signatory, and notarization date.
This affidavit submission requirement indicates that Lextran's landscaping services RFP (Reference Number 2026-03, with proposals due by 2:00 pm Eastern Time on Wednesday, June 3, 2026) includes incentives or set-asides for DBE participation. The form establishes a formal verification mechanism for proposers claiming DBE status to substantiate their qualification for potential contract awards or subcontracting opportunities designated for disadvantaged business enterprises. Submission of this affidavit is mandatory for any firm seeking to be evaluated or awarded work under DBE preferences within this procurement process.
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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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