Attach D-Qualified Bidder Affidavit.doc
DOC document 35 KB Posted
- Attached to
- Bunker Sand
- Solicitation number
- RFB 758 2100000180 1
- Issued by
- Cumberland County, Kentucky
About this file
This is a Qualified Bidder Affidavit document for Solicitation/Contract #RFB 758 2100000180 issued by a Kentucky state agency. The affidavit requires bidders and offerors to swear under penalty of perjury that they and all subcontractors meet the requirements to be considered "qualified bidders" in accordance with 200 KAR 5:410(3) and will maintain compliance throughout the contract duration. Bidders must identify their specific qualified bidder status claim, which may include being a nonprofit corporation that furthers the purposes of KRS Chapter 163 or a qualified nonprofit agency for individuals with severe disabilities under KRS 45A.465(3).
A qualified nonprofit agency for individuals with severe disabilities must be organized and operated in the interest of 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 man hours for manufactured or provided products and services listed under KRS 45A.470, and be registered in good standing as a nonprofit with the Kentucky Secretary of State. The bidding agency retains the right to request documentation supporting any claimed qualified bidder status, and failure to provide such documentation upon request may result in bidder disqualification or contract termination. The affidavit requires signature, notarization, and inclusion of the bidder's printed name, title, date, company name, and address.
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Text version
Solicitation/Contract #: RFB 758 2100000180 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 .