Attachment_K___Mercury_Affidavit.pdf
PDF 90 KB Posted
- Attached to
- DJS Phone Migration
- Solicitation number
- BPM049010
- Issued by
- Anne Arundel County, Harford County, St. Mary's County, Maryland
About this file
This document is a Mercury Affidavit for the State of Maryland, designed to be submitted with a bid or proposal to various governmental units including the State of Maryland, its counties and subdivisions, other states, and the federal government. The affidavit requires an authorized representative to declare whether the product(s) being offered contain mercury, with two possible response options: (1) the products do not contain mercury, or (2) the products do contain mercury, in which case the representative must provide details about the specific product components containing mercury and the amount of mercury present.
The affidavit includes a legal acknowledgment that the document is subject to applicable United States and Maryland state laws, both criminal and civil. The authorized representative must solemnly declare under penalties of perjury that the contents of the affidavit are true and correct to the best of their knowledge, information, and belief. The document is dated with an effective date of July 2024 and must be signed and submitted alongside the bid or proposal, serving as a compliance mechanism to ensure transparency about mercury content in products being offered to government entities.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT_A_-_Bid_Proposal_Affidavit.pdf | ||
| ATTACHMENT_L_-_Reference_Check.pdf | ||
| PORFP_DJS_Phone_Migration.pdf | ||
| ATTACHMENT_F_-_Bidder_Information_Sheet.pdf | ||
| Appendix_B__Bid_Form_B_.xlsx | XLSX spreadsheet | |
| ATTACHMENT__U_-_Contract_Affidavit.pdf | ||
| Appendix_A__Bid_Form_A_.xlsx | XLSX spreadsheet |
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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
File details come from the government source that posted it. Updated .