Attach C-Resident Bidder Affidavit.doc
DOC document 35 KB Posted
- Attached to
- GOLF COURSE CHEMICALS
- Solicitation number
- RFB 758 2100000161 2
- Issued by
- Kentucky
About this file
This is a Resident Bidder Affidavit form for solicitation RFB 758 2100000161, issued by a Kentucky state agency. The affidavit is a required document for bidders and offerors claiming resident bidder status under KRS 45A.494(2). Bidders must affirm under penalty of perjury that their entity is authorized to transact business in the Commonwealth and meets specific residency requirements as of the contract advertisement date.
To qualify for resident bidder status, entities must demonstrate that for one year prior to and through the date of advertisement, they filed Kentucky income taxes, made payments to the Kentucky unemployment insurance fund, and maintained a valid Kentucky workers' compensation policy. The bidding agency reserves the right to request supporting documentation to verify resident bidder claims, and failure to provide such documentation upon request will result in bidder disqualification or contract termination. The affidavit must be completed with the bidder's signature, printed name, title, date, company name, and address, then subscribed and sworn to before a notary public.
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Text version
Solicitation/Contract #: RFB 758 2100000161 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 .