Attachment B Resident Bidder Status.xml

Attachment B REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS CLAIMING RESIDENT BIDDER STATUS FOR BIDS AND CONTRACTS IN GENERAL: The bidder or offeror hereby swears and affirms under penalty of perjury that, in accordance with KRS 45A.494(2), the entity bidding is an individual, partnership, association, corporation, or other business entity that, on the date the contract is first advertised or announced as available for bidding: 1. Is authorized to transact business in the Commonwealth; 2. Has for one year prior to and through the date of advertisement a. Filed Kentucky income taxes ; b. Made payments to the Kentucky unemployment insurance fund established in KRS 341.49; and c . Maintained a Kentucky workers’ compensation policy in effect. The BIDDING AGENCY reserves the right to request documentation supporting a bidder’s claim of resident bidder status. Failure to provide such documentation upon request shall 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: Normal 1 1 199 1137 Microsoft Office Word 0 9 2 false Title 1 COT false 1334 false false 16.0000 Milby, Brandon O (KYTC) Milby, Brandon O (KYTC) 2 2020-02-20T18:30:00Z 2020-02-20T18:34:00Z