Attach C-Resident Bidder Affidavit.doc
DOC document 35 KB Posted
- Attached to
- TRUCK BED COVERS
- Solicitation number
- RFB 758 2000000596 2
- Issued by
- Elliott County, Kentucky
About this file
This is a Resident Bidder Affidavit required for Solicitation/Contract #RFB 758 2000000596. Bidders claiming resident bidder status must certify under penalty of perjury that they meet specific Kentucky residency requirements. The affidavit applies to individuals, partnerships, associations, corporations, and other business entities that must demonstrate authorization to transact business in the Commonwealth on the date the contract is first advertised for bidding.
To qualify for resident bidder status, entities must verify compliance with three requirements for the one-year period prior to and through the advertisement date: filing Kentucky income taxes, making payments to the Kentucky unemployment insurance fund, and maintaining an active Kentucky workers' compensation policy. The bidding agency reserves the right to request documentation supporting any claim of resident bidder status, and failure to provide such documentation upon request will result in bidder disqualification or contract termination. The affidavit requires the bidder's signature, printed name, title, date, company name, address, and notarization by a notary public.
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Text version
Solicitation/Contract #: RFB 758 2000000596 REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS CLAIMING RESIDENT BIDDER STATUS
FOR BIDS AND CONTRACTS IN GENERAL:
The bidder or offeror hereby swears and affirms under penalty of perjury that, in accordance with KRS 45A.494(2), the entity bidding is an individual, partnership, association, corporation, or other business entity that, on the date the contract is first advertised or announced as available for bidding:
1. Is authorized to transact business in the Commonwealth;
2. Has for one year prior to and through the date of advertisement
a. Filed Kentucky income taxes;
b. Made payments to the Kentucky unemployment insurance fund established in KRS 341.49; and
c. Maintained a Kentucky workers’ compensation policy in effect.
The BIDDING AGENCY reserves the right to request documentation supporting a bidder’s claim of resident bidder status. Failure to provide such documentation upon request shall result in disqualification of the bidder or contract termination.
Signature
Printed Name
Title
Date
Company Name
Address
Subscribed and sworn to before me by
(Affiant)
(Title) of this _____day of ____________,20___.
(Company Name)
Notary Public
[seal of notary]
My commission expires:
File details come from the government source that posted it. Updated .