Attach D-Qualified Bidder Affidavit.doc
DOC document 35 KB Posted
- Attached to
- Tote Barge Shocking System
- Solicitation number
- RFB 758 2100000198 1
- Issued by
- Elliott County, Kentucky
About this file
This is a Qualified Bidder Affidavit required for RFB 758 2100000198, applicable to bidders and contractors seeking qualified bidder status under Kentucky procurement regulations. The affidavit requires bidding entities and all subcontractors to confirm compliance with 200 KAR 5:410(3) requirements and maintain such compliance throughout the contract term. Bidders must identify the specific qualified bidder status being claimed and provide supporting documentation upon request by the bidding agency.
The affidavit addresses two primary qualified bidder classifications: 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). The latter designation requires the organization to be organized for 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 in manufacturing or providing listed products or services, and maintain registered nonprofit status in good standing with the Secretary of State. The bidding agency reserves the right to request documentation verifying qualified bidder status claims, and failure to provide such documentation may result in bidder disqualification or contract termination. The affidavit must be sworn before a notary public.
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Text version
Solicitation/Contract #: RFB 758 2100000198 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:
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