Attachment B Resident Bidder Status.xml.pdf

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Attached to
ARC Road Pavement and Air Sensors
Solicitation number
RFB 605 2100000467 1
Issued by
Kentucky

About this file

This is an affidavit form for resident bidder status claims required by the Commonwealth of Kentucky for bids and contracts in general. The affidavit must be completed by bidders, offerors, and contractors seeking to claim resident bidder status in accordance with KRS 45A.494(2). To qualify, the bidding entity must be an individual, partnership, association, corporation, or other business entity that is authorized to transact business in Kentucky as of the contract advertisement date. The entity must demonstrate continuous compliance for one year prior to and through the advertisement date by filing Kentucky income taxes, making payments to the Kentucky unemployment insurance fund, and maintaining an active Kentucky workers' compensation policy.

The bidding agency reserves the right to request documentation substantiating any claim of resident bidder status, and bidders must provide such documentation upon request or face disqualification or contract termination. The affidavit requires the bidder's signature, printed name, title, date, company name, and address, and must be notarized with the notary public's seal and commission expiration date included. This form ensures that entities claiming resident bidder status meet all statutory requirements established by the Commonwealth of Kentucky.

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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:

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