Final_RFB_605_1900000149_2_SO_FORM.PDF
PDF 14 MB Posted
- Solicitation number
- RFB 605 1900000149 2
- Issued by
- Elliott County, Kentucky
About this file
This is a Request for Bid (RFB) issued by the Commonwealth of Kentucky, specifically the Kentucky Transportation Cabinet (KYTC) Division of Purchases, for the procurement of precast drainage structures and steel grates serving Districts 1-3. The solicitation seeks various precast concrete drainage components including drop box inlets (Types 1-7, 10, 11, 13G, 13S, 16G, 16S), sloped box outlets, curb box inlets, steel grates for these structures, concrete median barrier box inlets, frame and lid assemblies, security devices, reinforced concrete pipe (54-inch RCP), concrete risers, and precast reinforced concrete box culvert sections ranging from 3'x3' to 6'x6' in various lengths. Line items total 90, with quantities varying from 3 to 30 units depending on the item type and measurement basis (EA, PR, FT, or LNFT). The solicitation was issued on August 31, 2018, as Addendum #2, with the bid closing date of September 19, 2018, at 10:00 a.m. Bids must be submitted to KYTC Division of Purchases Bid Clerk at 200 Mero Street, 4th Floor, Frankfort, Kentucky 40622. Online bidding is prohibited. Contact for inquiries is Erin Eagan at 502-782-3979.
The bid evaluation criteria allocates 95 points to the bidder with the lowest price and 5 points to the bidder offering the best delivery time. All vendors must submit required affidavits including campaign finance compliance, tax registration, state tax compliance, and prohibition violations under KRS 11A.236. Resident bidders and qualified bidders claiming special status must submit additional sworn affidavits with supporting documentation. Bidders must be authorized to transact business in Kentucky, and for resident bidder status claims, must demonstrate one year of prior Kentucky income tax filing, unemployment insurance contributions, and active workers' compensation coverage. All products must conform to Kentucky Transportation Cabinet Standard Specifications for Road and Bridge Construction and referenced Standard Drawings. The billing address for KYTC is 200 Mero Street, 3rd Floor, Frankfort, Kentucky 40622. A signature from an authorized agent is required unless the response is submitted electronically.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Buy America Clause.pdf | ||
| KY DOH Security Device Assembly.pdf | ||
| District Map.pdf | ||
| Bid Sheet D1-3.xls | XLS spreadsheet | |
| Final_RFB_605_1900000149_1_SO_FORM.PDF | ||
| FHWA - 1273.pdf |
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Text version
Document ID: RFB 605 1900000149 Page: 1 of 25
Commonwealth of Kentucky
SOLICITATION MODIFICATION
Addenda: Yes Addenda #: 2
TITLE: Precast Drainage Structures and Steel Grates Districts 1-3
Date Issued:
8/31/18 Record Date:
2018-08-31
Solicitation Closes Date:
9/19/18 Time:
10:00
Solicitation No:
RFB 605 1900000149
Online Bidding Prohibited: Yes
For Information Call:
Erin Eagan 502-782-3979
Bid Receiving Location:
KYTC Division of Purchases Bid Clerk 200 Mero Street 4th Floor Frankfort KY 40622
Vendor Customer Number:
Vendor Name:
Phone Number:
Fax Number:
Email Address:
Ordering
Address:
City, State, Zip:
Contact Name:
Contact Email:
Payment
Address:
City, State, Zip:
Contact Name:
Contact Email:
Ownership Type
__ Sole Proprietorship __ Partnership __ Corporation __ Other_________________________
SIGNATURE OF AUTHORIZED AGENT IS REQUIRED UNLESS RESPONSE
IS SUBMITTED ELECTRONICALLY. FAILURE TO SIGN SHALL RENDER
THE BID INVALID.
Signature X_________________________________________ FEIN#____________________ Date____________
All offers subject to all terms and conditions contained in this solicitation.
Document ID: RFB 605 1900000149 Page: 2 of 25
Line Items
Commodity Group: Default Commodity Group
Line CL Description Quantity UOM Unit Cost Line Total or Contract Amnt
1 Drop Box Inlet Type 1 3.00000 EA
Comm Code Comm Description Manufacturer Model # Manuf Part #
75030 Concrete, Precast
Extended Description Standard Drawing #RDB-001-12 "4' or less depth"
2 Drop Box Inlet Type 2 3.00000 EA
Standard Drawing # RDB-002-12 "4' or less depth"
3 Drop Box Inlet Type 3 3.00000 EA
Standard Drawing #RDB-003-08 "4' or less depth"
4 Drop Box Inlet Type 4 3.00000 EA
Standard Drawing # RDB-004-10 "4' or less depth"
Document ID: RFB 605 1900000149 Page: 3 of 25
5 Drop Box Inlet Type 5 3.00000 EA
Standard Drawing # RDB-005-09 "4' or less depth"
6 Drop Box Inlet Type 6 3.00000 EA
Standard Drawing #RDB-006-08 "4' or less depth"
7 Drop Box Inlet Type 7 3.00000 EA
Standard Drawing #RDB-007-03 "4' or less depth"
8 Drop Box Inlet Type 10 3.00000 EA
Standard Drawing #RDB-010-07 "4' or less depth"
Document ID: RFB 605 1900000149 Page: 4 of 25
9 Drop Box Inlet Type 11 3.00000 EA
Standard Drawing #RDB-011-08 "4' or less depth"
10 Drop Box Inlet Type 13G 3.00000 EA
Standard Drawing #RDB-013-07 "4' or less depth"
11 Drop Box Inlet Type 13S 3.00000 EA
Standard Drawing #RDB-013-07 "4' or less depth"
12 Drop Box Inlet Type 16G 3.00000 EA
Standard Drawing #RDB-030-04 "4' or less depth"
Document ID: RFB 605 1900000149 Page: 5 of 25
13 Drop Box Inlet Type 16S 3.00000 EA
Standard Drawing #RDB-030-04 "4' or less depth"
14 Sloped Box Outlet Type 1 15"/18" 3.00000 EA
Standard Drawing #RDB-100-05
15 Sloped Box Outlet Type 1 24" 3.00000 EA
Standard Drawing #RDB-100-05
16 Sloped and flared box inlet-outlet 15"/18" 3.00000 EA
Standard Drawing #RDB-105-06
Document ID: RFB 605 1900000149 Page: 6 of 25
17 Sloped and flared box inlet/outlet 24" 3.00000 EA
18 Sloped and flared box inlet/outlet 30" 3.00000 EA
19 Sloped and flared box inlet/outlet 36" 3.00000 EA
20 Curb Box Inlet Type A, 10' 3.00000 EA
Standard Drawing #RDB-270-09 "4' or less depth"
Document ID: RFB 605 1900000149 Page: 7 of 25
21 Curb Box Inlet Type B, 10' 3.00000 EA
Standard Drawing #RDB-280-06 "4' or less depth"
22 Concrete lid of curb box inlet type A-10' (no manhole)
3.00000 EA
Standard Drawing #RDB-270-09
23 Concrete lid of curb box inlet type B -10' (no manhole)
Standard Drawing #RDB-280-06
24 Standard Curb Box Inlet type F 3.00000 EA
Standard Drawing #RDB-320-06 "4' or less depth"
Document ID: RFB 605 1900000149 Page: 8 of 25
25 Drop Box Inlet Type 1 3.00000 EA
Standard Drawing #RDB-001-12 "greater than 4' up to 8' depth"
26 Drop Box Inlet Type 2 3.00000 EA
Standard Drawing #RDB-002-12 "greater than 4' up to 8' depth"
27 Drop Box Inlet Type 3 3.00000 EA
Standard Drawing #RDB-003-08 "Greater than 4' up to 8' depth"
28 Drop Box Inlet Type 4 3.00000 EA
Standard Drawing #RDB-004-10 "greater than 4' up to 8' depth"
Document ID: RFB 605 1900000149 Page: 9 of 25
29 Drop Box Inlet Type 5 3.00000 EA
Standard Drawing #RDB-005-09 "greater than 4' up to 8' depth"
30 Drop Box Inlet Type 6 3.00000 EA
Standard Drawing #RDB-006-08 "greater than 4' up to 8' depth"
31 Drop Box Inlet Type 7 3.00000 EA
Standard Drawing #RDB-007-03
32 Drop Box Inlet Type 10 3.00000 EA
Standard Drawing #RDB-010-07 "greater than 4' up to 8' depth"
Document ID: RFB 605 1900000149 Page: 10 of 25
33 Drop Box Inlet Type 11 3.00000 EA
Standard Drawing #RDB-011-08 "greater than 4' up to 8' depth"
34 Drop Box Inlet Type 13G 3.00000 EA
Standard Drawing #RDB-013-07 "greater than 4' up to 8' depth"
35 Drop Box Inlet Type 13S 3.00000 EA
Standard Drawing #RDB-013-07 "greater than 4' up to 8' depth"
36 Drop Box Inlet Type 16G 3.00000 EA
Standard Drawing #RDB-030-04 "greater than 4' up to 8' depth"
Document ID: RFB 605 1900000149 Page: 11 of 25
37 Drop Box Inlet Type 16S 3.00000 EA
Standard Drawing #RDB-030-04 "greater than 4' up to 8' depth"
38 Curb Box Inlet Type A, 10' 3.00000 EA
Standard Drawing #RDB-270-09 "greater than 4' up to 8' depth"
39 Curb Box Inlet Type B, 10' 3.00000 EA
Standard Drawing #RDB-280-06 "greater than 4' up to 8' depth"
40 Standard Curb Box Inlet Type F 3.00000 EA
Standard Drawing #RDB-320-06 "greater than 4' up to 8' depth"
Document ID: RFB 605 1900000149 Page: 12 of 25
41 Steel Grates for Drop Box Inlet Type 1 3.00000 PR
89030 Manholes, and Manhole Covers, Frames, Grates, Rings, Yokes, Provide Steel Grates for Drop Box Inlet Type 1 (2 grates) #RDB-001-12
42 Steel Grates for Drop Box Inlet Type 2 3.00000 PR
Provide steel grates for drop box inlet Type 2 (2 grates) #RDB-002-12
43 Steel grates for Drop Box Inlet Type 3 3.00000 PR
Provide steel grates for drop box inlet type 3 (2 grates) #RDB-003-08
44 Steel Grates for Drop Box Inlet Type 4 3.00000 PR
Provide steel grates for drop box inlet type 4 (2 grates) #RDB-004-10
Document ID: RFB 605 1900000149 Page: 13 of 25
45 Steel Grate for Drop Box Inlet Type 5 A-F 3.00000 PR
Provide steel grates for drop box inlet type 5 A-F (2 grates) #RDB-005-09
46 Steel Grates for Drop Box Inlet Type 6 A-F 3.00000 PR
Provide Steel Grates for Drop Box Inlet Type 6 A-F (2 grates) #RDB-006-08
47 Steel Grate for Drop Box Inlet Type 7 3.00000 PR
Provide steel grates for drop box inlet type 7 (2 grates) #RDB-007-03
48 Steel Grate for Drop Box Inlet Type 10 3.00000 EA
Provide steel grates for drop box inlet Type 10 #RDB-010-07
Document ID: RFB 605 1900000149 Page: 14 of 25
49 Steel Grate for Drop Box Inlet Type 11 3.00000 EA
Provide steel grates for drop box inlet type 11 #RDB-011-08
50 Steel Grate for Drop Box Inlet Type 12 3.00000 EA
Provide steel grates for drop box inlet type 12 #RDB-012-10
51 Steel Grate for Drop Box Inlet Type 12A 3.00000 EA
Provide Steel Grates for Drop Box Inlet Type 12A #RDB-012-10
52 Steel Grate for Drop Box Inlet Type 13G or Type 16G
Provide Steel Grates for drop box inlet type 13G or 16G #RDB-014-06
Document ID: RFB 605 1900000149 Page: 15 of 25
53 Steel Grate for Drop Box Inlet Type 13S or Type 16S
Provide steel grates for drop box inlet type 13S or 16S #RDB-014-06
54 Steel Grate for Drop Box Inlet Type 14 3.00000 EA
Provide steel grates for drop box inlet type 14 #RDB-020-05
55 Steel Grate for Drop Box Inlet Type 15 3.00000 EA
Provide steel grates for drop box inlet type 15 #RDB-020-05
56 15-18" Sloped Box Outlet Type 1-Grate 1 3.00000 EA
Provide steel grates for 15"-18" sloped box outlet type 1-grate 1 #RDB-101-05
Document ID: RFB 605 1900000149 Page: 16 of 25
57 15"-18" Sloped Box Outlet Type 1-Grate 2 3.00000 EA
Provide steel grates for 15"-18" sloped box outlet type 1-grate 2 #RDB-101-05
58 24" Sloped Box Outlet Type 1 - Grate 1 3.00000 EA
Provide steel grates for 24" sloped box outlet type 1-grate 1 or 2 #RDB-101-05
59 24" Sloped Box Outlet Type 1 - Grate 2 3.00000 EA
Provide steel grates for 24" sloped box outlet type 1 - grate 2 #RDB-101-05
60 30" Sloped and Flared Box Inlet/Outlet - Grate
Provide steel grates for 30" sloped and flared box inlet/outlet - grate 1 #RDB-106-05
Document ID: RFB 605 1900000149 Page: 17 of 25
61 30" Sloped and Flared Box Inlet/Outlet - Grate
Provide steel grates for 30" sloped and flared box inlet/outlet - grate 2 #RDB-106-05
62 30" Sloped and Flared Box Inlet/Outlet - Grate
Provide steel grates for 30" sloped and flared box inlet/outlet - grate 3 #RDB-106-05
63 36" Sloped and Flared Box Inlet/Outlet - Grate
Provide steel grates for 36" sloped and flared box inlet/outlet - grate 1 #RDB-106-05
64 36" Sloped and Flared Box Inlet/Outlet - Grate
Provide steel grates for 36" sloped and flared box inlet/outlet - grate 2 #RDB-106-05
Document ID: RFB 605 1900000149 Page: 18 of 25
65 36" Sloped and Flared Box Inlet/Outlet - Grate
Provide steel grates for 36" sloped and flared box inlet/outlet - grate 3 #RDB-106-05
66 36" Sloped and Flared Box Inlet/Outlet - Grate
Provide steel grates for 36" sloped and flared box inlet/outlet - grate 4 #RDB-106-05
67 Sloped Box Inlet or Outlet Type 1 - Grate 1 3.00000 EA
Provide steel grates for sloped box inlet or outlet type 1 - grate 1 #RDB-110-08
68 Sloped Box Inlet or Outlet Type 1 - Grate 2 3.00000 EA
Provide steel grates for sloped box inlet or outlet type 1 - grate 2 #RDB-110-08
Document ID: RFB 605 1900000149 Page: 19 of 25
69 Sloped Box Inlet or Outlet Type 2 - Grate 1 3.00000 EA
Provide steel grates for sloped box inlet or outlet - type 2 - grate 1 #RDB-111-08
70 Sloped Box Inlet or Outlet Type 2 - Grate 2 3.00000 EA
Provide steel grates for sloped box inlet or outlet type 2 - grate 2 #RDB-111-08
71 Concrete Median Barrier Box Inlet 3.00000 EA
Provide steel grates for concrete median barrier box inlet #RDB-231-11
72 Curb Box Inlet Type B 3.00000 EA
Provide Steel Grates for Curb Box Inlet Type B #RDB-282-04
Document ID: RFB 605 1900000149 Page: 20 of 25
73 Standard Curb Box Inlet Type F 3.00000 EA
Provide steel grates for standard curb box inlet type F #RDB-320-06
74 Frame and Lid Type 1 3.00000 EA
Provide Steel Lid for frame and lid type 1 #RDM-100-02
75 Frame and Lid Type 2 3.00000 EA
Provide steel lid for frame and lid type 2 #RDM-105-02
76 Security Device with 1 socket - order in groups of 10
A stainless steel security device and hardware to fasten grates to DBI, headwalls, etc., in an effort to defer theft. Security device shall include one (1) security plate, (2) stainless steel all-thread rods, 5 inches in length, two (2) tri-groove nuts, one tri-groove socket tool, two (2)galvanized washers, and (2) hammer epoxy capsules. Minimum quantity of 10 per order.
Document ID: RFB 605 1900000149 Page: 21 of 25
77 Security Device with 2 sockets - order in groups of 50
A stainless steel security device and hardware to fasten grates to DBI, headwalls, etc., in an effort to defer theft. Security device shall include one (1) security plate, (2) stainless steel all-thread rods, 5 inches in length, two (2) tri-groove nuts, two (2) tri-groove socket tools, two (2)galvanized washers, and
(2) hammer epoxy capsules. Minimum quantity of 50 per order.
78 54 inch RCP 6.00000 FT
Vendor shall provide 54" reinforced concrete pipe that conforms to Standard Drawing #RDI-003-05
79 24"x24"x6" Concrete Riser 10.00000 EA
Vendor shall provide concrete risers that conform to the Standard Specifications for Road and Bridge Construction
80 DELETED 0.00000 EA
01078 Pipe and Tubing Insulation, All Types
***LINE ITEM DELETED***
Document ID: RFB 605 1900000149 Page: 22 of 25
81 Precast Reinforced Concrete Box Culvert 3'X3' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 3'X3'X6' in length
82 Precast Reinforced Concrete Box Culvert 3'X4' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 3'X4'X6'
83 Precast Reinforced Concrete Box Culvert 3'X5' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 3'X5'X6'
84 Precast Reinforced Concrete Box Culvert 3'X6' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 3'X6'X6'
Document ID: RFB 605 1900000149 Page: 23 of 25
85 Precast Reinforced Concrete Box Culvert 4'X4' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 4'X4'X6'
86 Precast Reinforced Concrete Box Culvert 4'X5' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 4'X5'X6'
87 Precast Reinforced Concrete Box Culvert 4'X6' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 4'X6'X6'
88 Precast Reinforced Concrete Box Culvert 5'X5' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 5'X5'X6'
Document ID: RFB 605 1900000149 Page: 24 of 25
89 Precast Reinforced Concrete Box Culvert 5'X6' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 5'X6'X6'
90 Precast Reinforced Concrete Box Culvert 6'X6' 30.00000 LNFT
Extended Description Precast Reinforced Concrete Box Culvert Sections that conform to Section 611 of the Standard Specifications for Road and Bridge Construction 6'X6'X6'
Shipping Information KYTC Project Site
Project Site
N/A KY
Billing Information KYTC Division of Maintenance
200 Mero Street 3rd Floor Frankfort KY 40622
Document ID: RFB 605 1900000149 Page: 25 of 25
Submission Checklist
The following items will be required to be submitted with bid:
Item The bidder with the lowest Price receives the maximum score - 95pts.
The bidder with the best Delivery time receives the maximum score - 5pts.
Vendors can use this website to view bid opportunities for the Commonwealth. Vendors with an account can update their company information (addresses, contact persons, etc) and sign up to receive email notifications of bid opportunities. New to VSS – vendors will be able to download and print copies of contracts and view payment history. All Vendors must login to activate their account and to select the commodity code(s) associated with your business in order to receive future email notifications.
Document Description Page 25
1900000149 Precast Drainage Structures and Steel Grates Districts 1-3 of 48 https://emars311.ky.gov mailto:Finance.CRCGroup@ky.gov http://finance.ky.gov/services/policies
Document Description Page 26
1900000149 Precast Drainage Structures and Steel Grates Districts 1-3 of 48 http://transportation.ky.gov/Construction/Pages/Kentucky-Standard-Specifications.aspx http://transportation.ky.gov/Highway-Design/Pages/Standard-Drawings.aspx
Document Description Page 27
Document Description Page 28
Document Description Page 29
Document Description Page 30
Document Description Page 31 http://www.lrc.ky.gov/KRS/014A09/010.PDF http://www.lrc.ky.gov/KRS/014A09/030.PDF
Document Description Page 32 https://secure.kentucky.gov/sos/ftbr/welcome.aspx
Document Description Page 33
Document Description Page 34 mailto:Erin.Eagan@ky.gov
Document Description Page 35 https://emars311.ky.gov
Document Description Page 36 http://www.merriam-webster.com/dictionary/seal
Document Description Page 37
Document Description Page 38 http://finance.ky.gov/services/policies
Document Description Page 39
Document Description Page 40
Document Description Page 41
Document Description Page 42
Document Description Page 43
ANNUAL AFFIDAVIT FOR BIDDERS, OFFERORS, AND CONTRACTORS
FOR OFFICIAL USE ONLY:
Dates will be completed by Purchasing Staff Maximum Length One-Year
Affidavit Effective Date: ___________________
Affidavit Expiration Date: __________________
REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS
FOR BIDS AND CONTRACTS IN GENERAL:
I. Each bidder or offeror swears and affirms under penalty of perjury, that to the best of their knowledge:
a. In accordance with KRS 45A.110 and KRS 45A.115, neither the bidder or offeror as defined in KRS 45A.070(6), nor the entity which he/she represents, has knowingly violated any provisions of the campaign finance laws of the Commonwealth of Kentucky; and the award of a contract to the bidder or offeror or the entity which he/she represents will not violate any provisions of the campaign finance laws of the Commonwealth.
b. The bidder or offeror swears and affirms under penalty of perjury that, to the extent required by Kentucky law, the entity bidding, and all subcontractors therein, are aware of the requirements and penalties outlined in KRS 45A.485; have properly disclosed all information required by this statute;
and will continue to comply with such requirements for the duration of any contract awarded.
c. The bidder or offeror swears and affirms under penalty of perjury that, to the extent required by Kentucky law, the entity bidding, and its affiliates, are duly registered with the Kentucky Department of Revenue to collect and remit the sales and use tax imposed by KRS Chapter 139, and will remain registered for the duration of any contract awarded.
d. The bidder or offeror swears and affirms under penalty of perjury that the entity bidding is not delinquent on any state taxes or fees owed to the Commonwealth of Kentucky and will remain in good standing for the duration of any contract awarded.
e. The bidder or offeror swears and affirms that the entity bidding, and all subcontractors therein, have not violated any of the prohibitions set forth in KRS 11A.236 during the previous ten (10) year, and further pledge to abide by the restrictions set forth in such statute for the duration of the contract awarded.
FOR “NON-BID” CONTRACTS (I.E. SOLE-SOURCE; NOT-PRACTICAL OR FEASIBLE TO BID; OR
EMERGENCY CONTRACTS, ETC):
II. Each contractor further swears and affirms under penalty of perjury, that to the best of their knowledge:
a. In accordance with KRS 121.056, and if this is a non-bid contract, neither the contractor, nor any member of his/her immediate family having an interest of 10% or more in any business entity involved in the performance of any contract awarded, have contributed more than the amount specified in KRS 121.150 to the campaign of the gubernatorial slate elected in the election last preceding the date of contract award.
Document Description Page 44 http://www.lrc.state.ky.us/KRS/045A00/110.PDF http://www.lrc.state.ky.us/KRS/045A00/115.PDF http://www.lrc.state.ky.us/KRS/045A00/070.PDF http://www.lrc.state.ky.us/KRS/045A00/485.PDF http://www.lrc.ky.gov/KRS/139-00/CHAPTER.HTM http://www.lrc.ky.gov/KRS/121-00/056.PDF http://www.lrc.ky.gov/KRS/121-00/150.PDF
b. In accordance with KRS 121.330(1) and (2), and if this is a non-bid contract, neither the contractor, nor officers or employees of the contractor or any entity affiliated with the contractor, nor the spouses of officers or employees of the contractor or any entity affiliated with the contractor, have knowingly contributed more than $5,000 in aggregate to the campaign of a candidate elected in the election last preceding the date of contract award that has jurisdiction over this contract award.
c. In accordance with KRS 121.330(3) and (4), and if this is a non-bid contract, to the best of his/her knowledge, neither the contractor, nor any member of his/her immediate family, his/her employer, or his/her employees, or any entity affiliated with any of these entities or individuals, have directly solicited contributions in excess of $30,000 in the aggregate for the campaign of a candidate elected in the election last preceding the date of contract award that has jurisdiction over this contract.
As a duly authorized representative for the bidder, offeror, or contractor, I have fully informed myself regarding the accuracy of all statements made in this affidavit, and acknowledge that the Commonwealth is reasonably relying upon these statements, in making a decision for contract award and any failure to accurately disclose such information may result in contract termination, repayment of funds and other available remedies under law. If the bidder bidder, offeror, or contractor becomes non-compliant with any statement during the affidavit effective period, I will notify the Finance and Administration Cabinet, Office of Procurement Services immediately. I understand that the Commonwealth retains the right to request an updated affidavit at any time.
Signature Printed Name
Title Date
Company Name
Address
Commonwealth of Kentucky Vendor Code (if known) _______________________________
Subscribed and sworn to before me by (Affiant) (Title) of this _____day of ____________,20___.
(Company Name)
Notary Public [seal of notary] My commission expires:
Document Description Page 45 http://www.lrc.ky.gov/KRS/121-00/330.PDF http://www.lrc.ky.gov/KRS/121-00/330.PDF
Attachment D
REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND
CONTRACTORS CLAIMING RESIDENT BIDDER STATUS
The bidder or offeror hereby swears and affirms under penalty of perjury that, in accordance with KRS 45A.494(2), the entity bidding is an individual, partnership, association, corporation, or other business entity that, on the date the contract is first advertised or announced as available for bidding:
1. Is authorized to transact business in the Commonwealth;
2. Has for one year prior to and through the date of advertisement
a. Filed Kentucky income taxes;
b. Made payments to the Kentucky unemployment insurance fund established in KRS 341.49; and
c. Maintained a Kentucky workers’ compensation policy in effect.
The BIDDING AGENCY reserves the right to request documentation supporting a bidder’s claim of resident bidder status. Failure to provide such documentation upon request shall result in disqualification of the bidder or contract termination.
Document Description Page 46
Attachment E
REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS
CLAIMING QUALIFIED BIDDER STATUS
I. The bidder or offeror swears and affirms under penalty of perjury that the entity bidding, and all subcontractors therein, meets the requirements to be considered a “qualified bidder” in accordance with 200 KAR 5:410(3); and will continue to comply with such requirements for the duration of any contract awarded.
Please identify below the particular “qualified bidder” status claimed by the bidding entity.
________ A nonprofit corporation that furthers the purposes of KRS Chapter 163
_______ Per KRS 45A.465(3), a "Qualified nonprofit agency for individuals with severe disabilities" means an organization that:
(a) Is organized and operated in the interest of individuals with severe disabilities; and
(b) Complies with any applicable occupational health and safety law of the United States and the Commonwealth; and
(c) In the manufacture or provision of products or services listed or purchased under KRS 45A.470, during the fiscal year employs individuals with severe disabilities for not less than seventy-five percent (75%) of the man hours of direct labor required for the manufacture or provision of the products or services; and
(d) Is registered and in good standing as a nonprofit organization with the Secretary of State.
The BIDDING AGENCY reserves the right to request documentation supporting a bidder’s claim of qualified bidder status. Failure to provide such documentation upon request may result in disqualification of the bidder or contract termination.
Document Description Page 47 http://www.lrc.state.ky.us/kar/200/005/410reg.htm http://www.lrc.state.ky.us/kar/200/005/410reg.htm
File details come from the government source that posted it. Updated .