Attach D-Qualified Bidder Affidavit.doc
DOC document 35 KB Posted
- Attached to
- TRUCK BED COVERS
- Solicitation number
- RFB 758 2000000596 2
- Issued by
- Elliott County, Kentucky
About this file
This is a Qualified Bidder Affidavit form for Solicitation/Contract #RFB 758 2000000596, establishing requirements for bidders seeking qualified bidder status in accordance with 200 KAR 5:410(3). Bidders and all subcontractors must affirm under penalty of perjury that they meet the qualifications to be considered a "qualified bidder" and will maintain compliance throughout the contract duration. The affidavit requires bidders to identify their specific qualified bidder status claim, with options including 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).
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 of the United States and the Commonwealth, employ individuals with severe disabilities for not less than seventy-five percent of direct labor man hours in the manufacture or provision of listed or purchased 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 claim of qualified bidder status, with failure to provide such documentation upon request resulting in potential disqualification or contract termination. The affidavit requires execution before a notary public with the affiant's signature, printed name, title, company name, and address.
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Text version
Solicitation/Contract #: RFB 758 2000000596 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 .