Attach D Qualified Bidder Affidavit.doc

DOC document 35 KB Posted

Attached to
ELK TRACKING COLLARS
Solicitation number
RFB 758 1900000563 2
Issued by
Elliott County, Kentucky

About this file

This is a Qualified Bidder Affidavit document for RFB 758 1900000563, establishing requirements for bidders and subcontractors seeking qualified bidder status in accordance with 200 KAR 5:410(3). Bidders must affirm under penalty of perjury that they and all subcontractors meet qualified bidder requirements and will maintain compliance throughout the contract term. The affidavit allows bidders to claim status as either a nonprofit corporation that furthers the purposes of KRS Chapter 163 or a qualified nonprofit agency for individuals with severe disabilities as defined under KRS 45A.465(3).

To qualify as a nonprofit agency for individuals with severe disabilities, an organization must be organized and operated in the interest of such individuals, comply with applicable occupational health and safety laws of the United States and Kentucky, employ individuals with severe disabilities for no less than seventy-five percent of direct labor man hours in the manufacture or provision of listed products or services, and maintain registration and good standing as a nonprofit organization with the Secretary of State. The bidding agency reserves the right to request documentation supporting a bidder's qualified bidder status claim, and failure to provide such documentation upon request may result in bidder disqualification or contract termination. The affidavit requires signature, printed name, title, date, and company information, and must be notarized.

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Text version

Solicitation/Contract #: RFB 758 1900000563 REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS CLAIMING QUALIFIED BIDDER STATUS

FOR BIDS AND CONTRACTS IN GENERAL:

I. The bidder or offeror swears and affirms under penalty of perjury that the entity bidding, and all subcontractors therein, meets the requirements to be considered a “qualified bidder” in accordance with 200 KAR 5:410(3); and will continue to comply with such requirements for the duration of any contract awarded. Please identify below the particular “qualified bidder” status claimed by the bidding entity.

________ A nonprofit corporation that furthers the purposes of KRS Chapter 163 _______ Per KRS 45A.465(3), a "Qualified nonprofit agency for individuals with severe disabilities" means an organization that:

(a) Is organized and operated in the interest of individuals with severe disabilities; and

(b) Complies with any applicable occupational health and safety law of the United States and the Commonwealth; and

(c) In the manufacture or provision of products or services listed or purchased under KRS 45A.470, during the fiscal year employs individuals with severe disabilities for not less than seventy-five percent (75%) of the man hours of direct labor required for the manufacture or provision of the products or services; and

(d) Is registered and in good standing as a nonprofit organization with the Secretary of State.

The BIDDING AGENCY reserves the right to request documentation supporting a bidder’s claim of qualified bidder status. Failure to provide such documentation upon request may 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 .