Attach C Resident Bidder Affidavit.doc
DOC document 48 KB Posted
- Attached to
- GOLF COURSE CHEMICALS-SYNGENTA
- Solicitation number
- RFB 758 2000000258 1
- Issued by
- Elliott County, Kentucky
About this file
This is a Resident Bidder Affidavit form required for solicitation RFB 758 2000000258, applicable to bidders and contractors seeking resident bidder status in Kentucky. The affidavit serves as a sworn statement under penalty of perjury confirming that the bidding entity meets established residency requirements on the date the contract is first advertised. Bidders must certify they are authorized to transact business in the Commonwealth and have maintained compliance with state requirements for the one-year period prior to and through the date of advertisement, including 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 claimed resident bidder status, and failure to provide such documentation upon request will result in bidder disqualification or contract termination. The affidavit must be signed by an authorized representative of the bidding entity, printed with the signatory's name and title, dated, and notarized before a notary public bearing the notary's seal and commission expiration date.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_758_2000000258_1_SO_FORM.PDF | ||
| ATTACH A - 758 2000000258.pdf | ||
| Attach D Qualified Bidder Affidavit.doc | DOC document | |
| Attach B ANNUAL AFFIDAVIT.pdf |
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Text version
Solicitation/Contract #: RFB 758 2000000258 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 .