Attach D Qualified Bidder Affidavit.doc
DOC document 35 KB Posted
- Attached to
- Horse Show Floral Garlands
- Solicitation number
- RFB 758 2000000593 1
- Issued by
- Bath County, Kentucky
About this file
This is a Qualified Bidder Affidavit document for Solicitation/Contract #RFB 758 2000000593 issued by a state procurement agency. The affidavit serves as a required certification form for bidders and offerors seeking to claim qualified bidder status on state and local contracts. Bidders must affirm under penalty of perjury that they and all subcontractors meet the requirements established under 200 KAR 5:410(3) and commit to maintaining compliance throughout the contract term. The document requires bidders to identify the specific qualified bidder status they are claiming and must be notarized with the bidder's signature, printed name, title, date, company name, and address.
The affidavit addresses qualified bidder classifications, including nonprofit corporations that further the purposes of KRS Chapter 163 and qualified nonprofit agencies for individuals with severe disabilities as defined under KRS 45A.465(3). Organizations claiming the latter status must demonstrate that they are organized to serve individuals with severe disabilities, comply with applicable occupational health and safety laws, employ individuals with severe disabilities for at least seventy-five percent of direct labor hours on listed or purchased products and services, and maintain registration in good standing as a nonprofit with the Kentucky Secretary of State. The bidding agency reserves the right to request supporting documentation for any qualified bidder status claim, and failure to provide such documentation upon request may result in bidder disqualification or contract termination.
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Text version
Solicitation/Contract #: RFB 758 2000000593 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 .