Attachment-J.-Mercury-Affidavit.pdf
PDF 68 KB Posted
- Solicitation number
- BPM059405
- Issued by
- Baltimore County, Maryland
About this file
This is a Mercury Affidavit form for the State of Maryland, effective July 2024, required as part of the procurement process for contract opportunity FC0003799 regarding Juniper Equipment for the MMD BAS Network at Gunpowder. The affidavit must be completed and submitted with all bids and proposals by an authorized representative of the bidding business who possesses legal authority to execute the document on behalf of the organization.
The affidavit requires the bidder to declare under penalty of perjury whether the product(s) being offered contain mercury. If mercury is present, the bidder must provide a detailed attachment identifying the specific product or component containing mercury and specifying the quantity of mercury contained therein with the applicable unit of measure. The affidavit acknowledges that the document will be distributed to the State of Maryland, its counties and subdivisions, other states, and the federal government, and affirms that all statements are subject to applicable criminal and civil laws of the United States and Maryland. The bidder's submission is binding and cannot supersede or waive the state's statutory rights regarding any misrepresentation or breach of contract obligations related to the affidavit, contract terms, or related documentation.
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Other files
| File | Type | Posted |
|---|---|---|
| FC0003799 PORFP for Juniper HPE .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 .