Attach C Resident Bidder Affidavit.doc

This is a Resident Bidder Affidavit required for Solicitation/Contract #RFB 758 1900000231, applicable to bidders and offerors in the Commonwealth of Kentucky. The affidavit serves as a sworn statement under penalty of perjury for entities claiming resident bidder status. To qualify for resident bidder consideration, bidding entities must be authorized to transact business in Kentucky on the date the contract is first advertised and must have maintained compliance with state requirements for the one-year period preceding the advertisement date.

Qualifying entities must demonstrate three specific requirements: filing Kentucky income taxes, making payments to the Kentucky unemployment insurance fund, and maintaining an active Kentucky workers' compensation policy throughout the one-year period prior to and including the contract advertisement date. The bidding agency reserves the right to request supporting documentation to verify resident bidder status claims, and failure to provide requested documentation upon demand will result in bidder disqualification or contract termination. The affidavit must be completed with the bidder's signature, printed name, title, date, and company information, and must be notarized with the notary public's seal and commission expiration date.