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
This is an Affidavit of Compliance form for Disadvantaged Business Enterprise (DBE) certification, prepared for use by the Transit Authority of Lexington-Fayette Urban County Government (Lextran) in Kentucky for their On-Call Electrician Services contract opportunity (Reference Number 2026-01). The form is designed to be completed and notarized by proposers or subcontractors claiming DBE status. The affidavit requires the authorized representative of the company to declare under penalty of perjury that their firm qualifies as a DBE according to the specifications outlined in the RFP and that they will provide documentation to substantiate this designation. The document must be signed by the authorized representative, notarized, and submitted as part of the proposal package. Proposals are due by 2:00 pm eastern time on Thursday, April 23, 2026, via Lextran's eProcurement Portal.
The form contains standard notarization requirements, including the notary public's name, signature, and commission expiration date. The affidavit serves as a compliance mechanism for firms seeking to leverage their DBE status in the competitive bidding process. While the file itself does not specify pricing terms, funding sources, or contract duration, these details would be contained within the complete RFP documentation. The inclusion of this DBE affidavit form indicates that Lextran has incorporated disadvantaged business enterprise considerations into their procurement evaluation process for the on-call electrician services contract.
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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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