Attachment H Transmittal Letter Checklist.docx
DOCX document 146 KB Posted
- Attached to
- Street Sweepers, Repairs, Parts, and Service
- Solicitation number
- RFP 605 2200000036 2
- Issued by
- Kentucky
About this file
This is a Transmittal Letter Checklist for RFP 605 2200000036 issued by the Commonwealth of Kentucky. The checklist serves as a standardized attestation document that vendors must complete and submit with their proposals. The form requires vendors to confirm compliance with various statutory and regulatory requirements, identify key contract personnel including a proposal contact and a contract performance contact, and disclose whether subcontractors will be utilized in fulfilling the contract obligations.
The checklist includes nine primary certification items addressing exceptions or deviations to requirements, compliance with the Kentucky Civil Rights Act, adherence to the Executive Branch Code of Ethics, conflict of interest prohibitions, debarment status, and violations of KRS 45A.485. Vendors must provide signatures that are notarized and affirmed before a notary public. The document includes a dedicated section for vendors to document any exceptions or deviations to RFP requirements, with substantial space allocated for detailed explanations. Completion and submission of this checklist with notarized signature and seal is mandatory for proposal acceptance.
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Text version
Transmittal Letter Checklist _________________________________________(vendor)
RFP 605 2200000036
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 2200000034
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File details come from the government source that posted it. Updated .