Attachment-J.-Mercury-Affidavit.pdf
PDF 68 KB Posted
- Solicitation number
- BPM055776
- Issued by
- Howard County, Maryland
About this file
This is a Mercury Affidavit attachment related to the Maryland Department of Health Services (DHS) contract opportunity FC0001959 for CIENA AMR On-Net services at Building 355, 211 Schilling Circle. The affidavit serves as a supporting document for the bidding process, providing attestation regarding mercury content or mercury-related compliance matters pertinent to the proposed telecommunications or network services to be provided at the specified facility location.
The affidavit functions as a certification document requiring the contractor or service provider to attest to compliance with Maryland environmental or health regulations concerning mercury materials, substances, or equipment that may be involved in the installation, maintenance, or operation of the AMR (Automated Meter Reading) on-net services. This documentation is a mandatory component of the contract submission requirements and supports the State of Maryland's commitment to environmental stewardship and regulatory compliance in its procurement processes.
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Other files
| File | Type | Posted |
|---|---|---|
| Redacted BOM.docx | DOCX document | |
| FC0001959 PORFP for CIENA.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 .