Attachment D - Transmittal Letter Checklist.docx

DOCX document 146 KB Posted

Attached to
Retrofit Snow/Ice Trucks Districts 2, 4 and 6
Solicitation number
RFP 605 2100000291 3
Issued by
Gallatin County, Kentucky

About this file

This is a Transmittal Letter Checklist for RFP 605 2100000291 from the Commonwealth of Kentucky. The checklist serves as a compliance and certification document that vendors must complete and submit as part of their proposal response. The document requires vendors to confirm their adherence to various statutory and regulatory requirements, including compliance with the Kentucky Civil Rights Act, the Executive Branch Code of Ethics, prohibition of conflicts of interest, and debarment status. Vendors must identify a primary contact person for proposal submission and a separate contact person for contract performance, and must disclose whether subcontractors will be utilized on the project. The checklist also requires vendors to certify that they have not violated provisions under KRS 45A.485 and provides space for vendors to document any exceptions or deviations to the RFP requirements.

All responses must be notarized and signed by an authorized company representative. The document does not specify pricing terms, set-asides, funding amounts, or contract duration in the provided content. Vendors are required to provide detailed contact information including names, phone numbers, and email addresses for both proposal and performance contacts, and must list any proposed subcontractors if applicable. The checklist functions as a preliminary certification mechanism to ensure vendor eligibility and commitment to compliance with Kentucky state regulations and ethics standards prior to proposal evaluation.

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Text version

Transmittal Letter Checklist _________________________________________(vendor)

RFP 605 2100000291

1. Does your company take any exceptions or want to propose any deviations to the requirements?

Yes No If yes, please submit on the below page titled “Exceptions / Deviations”

2. Will your company comply with the Kentucky Civil Rights Act? Yes No

3. Has your company knowingly violated any provisions of the Executive Branch Cold of Ethics? Yes No

4. Is your company in compliance with Prohibition of Certain Conflicts of Interest? Yes No

5. Is your company, or any of its principals, debarred, suspended, proposed for debarment, or declared ineligible for award of state or federal contracts? Yes No

6. Contact person for proposal: ________________________________________(Name)

________________________________________(Phone)
_________________________________________(Email, alternate phone)

7. Contact person for contract performance: ________________________________________ (Name)

________________________________________ (Phone)
________________________________________(Email, alternate phone)

8. Will you be using subcontractors? Yes No If Yes, list here: ___________________________________________________________

___________________________________________________________
___________________________________________________________

9. Has your company been in violation of statutes as per KRS 45A.485? (see below)

Yes No
If yes, you must submit the required information regarding determinations as per KRS 45A.485.

Vendor Signature affirming the above and notary should be applied below.

Vendor 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:

Exceptions / Deviations

RFP 605 2100000291

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File details come from the government source that posted it. Updated .