Attachment-J.-Mercury-Affidavit.pdf
PDF 68 KB Posted
- Attached to
- PORFP R99P6601092 Cisco Access Points
- Solicitation number
- BPM056998
- Issued by
- Maryland
About this file
This is a Mercury Affidavit form required for submission with bids and proposals to the State of Maryland, effective July 2024. The affidavit pertains to a procurement opportunity issued by the Maryland School for the Deaf for 39 Access Points and associated mounts and brackets. Bidders are required to complete this form as part of their proposal submission process. The affidavit requires an authorized representative of the bidding business to certify under penalty of perjury whether the products being offered contain mercury or are mercury-free. If mercury is present in any product or component, bidders must provide detailed information including a description of the affected product or component and the specific amount of mercury contained, along with the unit of measurement.
The affidavit establishes that submitted information may be distributed to the State of Maryland, its counties and subdivisions, other states, and the federal government. Bidders acknowledge that the affidavit is subject to all applicable laws of the United States and the State of Maryland, both criminal and civil, and that any misrepresentation or violation of contractual obligations may result in legal consequences. The form must be signed and dated by an authorized representative with legal authority to execute the affidavit on behalf of the bidding business and submitted with the bid or proposal.
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Other files
| File | Type | Posted |
|---|---|---|
| Bid_Sheet_Cisco_AP__Project__for_PORFP_R99P6601092.xlsx | XLSX spreadsheet | |
| Attachment-I.-Conflict-of-Interest-Affidavit.pdf | ||
| PORFP_R99P6601092_Cisco_Access_Points.pdf |
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Text version
Attachment J – Mercury Affidavit Effective Date: July 2024
Attachment J. Mercury Affidavit
AUTHORIZED REPRESENTATIVE THEREBY AFFIRM THAT:
I, _______________________________ (name of affiant) am the _______________________________ (title) and the duly authorized representative of _______________________________ (name of the 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.
� In an attachment to this Mercury Affidavit:
(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 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
SUBMIT THIS AFFIDAVIT WITH BID/PROPOSAL
Attachment K. Mercury Affidavit
File details come from the government source that posted it. Updated .