ATTACHMENT H – Mercury Affidavit.pdf
PDF 74 KB Posted
- Attached to
- Noble IVR system
- Solicitation number
- BPM040933
- Issued by
- Maryland
About this file
The document provided is an Attachment H - Mercury Affidavit, which is required to be submitted as part of the procurement process for a state and local contract opportunity in the State of Maryland. The contract opportunity is for the maintenance and support of the Noble IVR Core system and Noble IVR License. The affidavit requires the authorized representative of the business to indicate whether the products offered contain mercury and, if so, to provide details on the amount and unit of measure. The affidavit also acknowledges that it may be distributed to various government entities and is subject to applicable laws of the United States and the State of Maryland.
The pricing terms, set asides, incumbents, funding requirements and sources, and other salient information are not provided in the document. The document focuses solely on the mercury affidavit requirements for the state and local contract opportunity.
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Other files
| File | Type | Posted |
|---|---|---|
| P00B4600017 updated.pdf |
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Text version
ATTACHMENT H – Mercury Affidavit
MERCURY AFFIDAVIT
AUTHORIZED REPRESENTATIVE THEREBY AFFIRM THAT:
I am the _________________ (Title) and the duly authorized representative of _______________________ (Business). I possess the legal authority to make this affidavit on behalf of myself and the business for which I am acting.
MERCURY CONTENT INFORMATION:
[ ] The product(s) offered do not contain mercury.
OR
[ ] The product(s) offered do contain mercury.
(1) Describe the product or product component that contains mercury.
(2) Provide the amount of mercury that is contained in the product or product component. Indicate the unit of measure being used.
I ACKNOWLEDGE THAT this affidavit is to be furnished to the procurement officer and may be distributed to units of (1) the State of Maryland; (2) counties or other subdivisions of the State of Maryland; (3) other states; and (4) the federal government. I further acknowledge that this Affidavit is subject to applicable laws of the United States and the State of Maryland, both criminal and civil, and that nothing in this affidavit or any contract resulting from the submission of this bid or proposal shall be construed to supersede, amend, modify, or waive, on behalf of the State of Maryland, or any unit of the State of Maryland having jurisdiction, the exercise of any statutory right or remedy conferred by the Constitution and the laws of Maryland with respect to any misrepresentation made or any violation of the obligations, terms and covenants undertaken by the above business with respect to (1) this affidavit, (2) the contract, and (3) other affidavits comprising part of the contract.
I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY
THAT THE CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE
BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF.
________________ By ___________________________ Date Signature
Print Name: _____________________________________ Authorized Representative and Affiant
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