Final_RFQ_128_2000000157_2_SO_FORM.PDF

Document ID: RFQ 128 2000000157 Page: 1

Commonwealth of Kentucky

SOLICITATION MODIFICATION

Addenda: Yes Addenda #: 2

TITLE: RFQ Janitorial Services-Pineville Branch Office

Date Issued:

6/23/20 Record Date:

2020-06-23

Solicitation Closes Date:

6/23/20 Time:

15:50

Solicitation No:

RFQ 128 2000000157

Online Bidding Prohibited: Yes

For Information Call:

Stephanie Benassi 502-782-7165

Bid Receiving Location:

Division of Forestry Stephanie Benassi 300 Sower Blvd, 4th Floor

Frankfort KY 40601

Vendor Customer Number:

Vendor Name:

Phone Number:

Fax Number:

Email Address:

Ordering

Address:

City, State, Zip:

Contact Name:

Contact Email:

Contact Phone Number:

Payment

Address:

City, State, Zip:

Contact Name:

Contact Email:

Contact Phone Number:

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: RFQ 128 2000000157 Page: 2

Line Items

Commodity Group: Default

Line CL Description Quantity UOM Unit Cost Line Total or Contract Amnt

1 Janitorial Services-Pineville, KY 11.00000 MO

Comm Code Comm Description Manufacturer Model # Manuf Part #

91039 Janitorial/Custodial Services

Extended Description A pre-bid site visit is not required on this contract. The site will be open for visits on 05/27/2020 at 10:00AM. Please contact Lem Johnson at 606-594-4679 or Lem.Johnson@ky.gov to verify your attendance.

Shipping Information Division of Forestry Stephanie Benassi 300 Sower Blvd, 4th Floor

Frankfort KY 40601

Billing Information Division of Forestry Stephanie Benassi 300 Sower Blvd, 4th Floor

Frankfort KY 40601

Document ID: RFQ 128 2000000157 Page: 3

Submission Checklist

The following items will be required to be submitted with bid:

Item Vendor price per month Vendor Experience Years in business Recommendation letter

COMMONWEALTH OF KENTUCKY

Energy and Environment Cabinet

Kentucky Division of Forestry

300 Sower Blvd, 4th FL SE Frankfort, KY 40601

Informal Solicitation for Nonprofessional Services

The Finance and Administration Cabinet Policy and Procedure FAP 110-10-00: General Conditions and Instructions for Solicitations and Contracts is hereby incorporated by reference into this solicitation.

Website for entire Policies and Procedure manual: https://finance.ky.gov/services/policies/Pages/ default.aspx

Solicitation Instructions:

Due Date for Response: 10:00AM EST July 8th, 2020

Site Visit:

A pre-bid site visit is not required on this contract. The site will be open for visits on 06/26/2020 at 10:00AM. Please contact Lem Johnson at 606-594-4679 or Lem.Johnson@ky.gov to verify your attendance.

Return Request for Quotation to the following EMAIL Address:

Subject: RFQ-128-2000000157-DO NOT OPEN Stephanie.benassi@ky.gov

Questions regarding this RFQ:

Questions shall be submitted via email to stephanie.benassi@ky.gov by 8:00AM Eastern Daylight Savings Time on 06/29/2020. No questions shall be accepted after the deadline. Oral questions shall not be accepted at any time. The Commonwealth will respond to salient questions in writing by issuing an Addendum to the Solicitation. The Addendum shall be posted 06/30/2020 to the Commonwealth’s E- Procurement Page. https://emars311.ky.gov/webapp/vssprdonline/AltSelfService

Agency Contact: (All Inquires) Stephanie Benassi Kentucky Division of Forestry

300 Sower Blvd, 4th Fl SE Frankfort, KY 40601 stephanie.benassi@ky.gov

Terms and Conditions:

Total Square Footage: 9,000 total SQ. FT

Total Employees: 16 (subject to change)

Location of Service:

Pineville Branch Office 12008 US Hwy 25E, Pineville, KY 40977

Period of Service: 08/01/2020 to 06/30/2021 with one optional year renewal.

Document Description Page 4

2000000157 RFQ Janitorial Services-Pineville Branch Office https://finance.ky.gov/services/policies/Pages/default.aspx https://finance.ky.gov/services/policies/Pages/default.aspx https://emars311.ky.gov/webapp/vssprdonline/AltSelfService

Agency:

The agency shall provide a secured storage space for the vendor’s equipment and disposable supplies;

such as toilet paper, paper towels, hand soap, antibacterial hand cleanser, trash can liners, etc. The agency shall provide light, water, and electricity as are necessary to perform the contracted services. The vendor will agree to use the agency’s supplies sparingly.

Vendor:

The vendor shall furnish all labor, materials, tools, cleaning supplies/chemicals, and equipment necessary for performing janitorial services; such as toilet bowl cleaner, streak free glass cleaner, furniture polish, floor and fixture cleaning detergents, floor waxes, brooms, rags, brushes, mops, large rolling garbage receptacles, mop bucket and floor care equipment including vacuum cleaners. The vendor will be responsible for satisfactory work in accordance with the intent of the specifications which are deemed necessary to keep the building in a clean and sanitary condition. The vendor shall be responsible for any breakage, damage, or loss through their carelessness. The vendor shall not use any product, supplies or equipment that are injurious or damaging to the surfaces to which they are applied or exposed. The vendor shall insure that all floor finishes will be non-staining, that they provide a high degree of slip protection, shine and that they meet the Underwriters Laboratories (UL) specifications. Disinfectant detergent cleaner shall be used for all normal cleaning purposes. Dust mop treatment materials which leave an oily residue shall not be used. The vendor shall be responsible for restoring/replacing any equipment, facilities, furniture, floor covering, etc. if so damaged. All employees shall be at least eighteen

(18) years of age and must be employees of the contracted vendor. Subcontracted employees will not be accepted. No one under the age of eighteen (18) and not employed by the vendor will have access to the facility. The vendor will be responsible for locking doors and turning off all lights as directed by the Agency. Vendor shall be issued keys/badges to the facility necessary to perform janitorial tasks and will be responsible to return those keys/badges upon termination of the contract. Vendor shall agree to pay a fee to cover the expenses of re-securing the facility if the key/badges become lost or non-accounted for.

A fee not to exceed one hundred dollars ($100.00) shall be determined by the Energy and Environment Cabinet, Office of Administrative Service representative. Upon the contract award, the vendor shall submit a list of materials and Material Safety Data Sheets (MSDS) that will be used in providing the janitorial service. Vendor is responsible to updating the MSD Sheets as additional chemicals are added. The agency may disapprove the use of any product.

Frequency of Services

Twice Weekly Services: Work will be performed on Monday and Thursday, after regular business hours.

1. Empty all waste baskets and trash receptacles and replace liners

2. Remove any and all trash from the building and place in dumpster

3. Vacuum, remove scuff marks, and wet mop all offices, entry/foyer, and hallways

4. Vacuum all entry door rugs

5. Wipe off phones

6. Clean entrance area and counter, including glass inside and out

Kitchen:

1. Clean and sanitize sinks, basins, counters, faucets, and table

2. Clean microwave inside and out

3. Clean and sanitize exterior of refrigerator

Restrooms:

1. Clean and sanitize sinks, basins, counters, and faucets

2. Clean and disinfect toilets inside and out, including seats and behind toilet

3. Clean and polish mirrors

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4. Clean and polish all metal work

5. Clean restroom dispensers

6. Sweep and mop all floors with germicidal cleaner

7. Fill soap, paper towel and toilet paper dispensers as needed

8. Empty all waste baskets and trash receptacles and replace liners

Monday or Thursday Services:

1. Dust all flat work services-including desks, tables, etc. without disturbing papers

2. Dust all clocks and file cabinet tops

3. Vacuum and wet mop training rooms and conference room

4. Wipe down tables and chairs in training rooms

Semi-Annual Services (August and February):

1. Strip and re-wax all tile floors, including bathroom floors

2. Clean wood work and light fixtures

3. Clean exhaust fans in restrooms

4. Damp wipe all vinyl-upholstered furniture and vacuum/lint roll all office chairs

Annual Services:

1. Wash all windows inside and out (first floor outside only)

2. Clean wall and door surfaces

3. Clean mini blinds

Inspection and Acceptance of Services:

Upon agency request, the vendor will provide a representative for an onsite inspection. During this inspection the vendor and agency will review the facility and discuss any improvements or changes, if needed.

Invoicing Instructions:

The vendor is responsible to submit the invoice to the agency at the address indicated per the contract on or before the 10th of the month following the month in which the service(s) were rendered. The agency representative will approve the vendor’s invoice before payment is authorized.

Payment Terms:

The Commonwealth shall pay all invoices in accordance with KRS 44.010, JRS 45.453 and KRS 45.454, which basically is “when due, and within 30 working days after receipt of an approved invoice.” Vendor with the ability to accept credit card transactions must accept the Commonwealth Procurement Card for payment of services.

Total cost restriction:

Cost of services shall not exceed $20,000 per fiscal year.

Taxes:

The agency shall furnish the tax exemption number for applicable tax exempt purchases.

Governmental Mandates (Workman’s Compensation, Unemployment Insurance, etc.):

The vendor is responsible for compliance with all applicable mandates concerning this agreement. For the purposes of this contract the vendor is deemed to be an independent agent and is not considered to be an employee of the Commonwealth. The agreement is governed by the laws of the Commonwealth of Kentucky.

Document Description Page 6

Vendor will keep in effect at all times the following insurance coverage: Workmen’s Compensation Insurance. Vendor’s Public Liability Insurance for personal injury. Vendor must furnish a Certificate of Insurance with the bid package.

It is the Vendor’s responsibility to maintain the required insurance coverage at all times. Failure to do so will result in cancellation of the contact.

Modifications to Contract:

The agency reserves the right to modify this agreement for the addition or deletion of requirements deemed necessary by the agency with the mutual agreement of both parties; however, modification will not result in the expenditures against this contract exceeding $20,000 per fiscal year.

Termination of Contract:

Either party may terminate the contract at any time for just cause, or either party may cancel this contract with thirty (30) days written notice.

Funding Out Provision:

The agency may terminate this contract if funds are not appropriated to the contracting agency or are not otherwise available for the purpose of making payments without incurring any obligation for payment after the date of termination, regardless of the terms of the contract. The agency shall provide the vendor thirty

(30) days written notice of termination of the contract.

Reduction in Contract Worker Hours:

The Kentucky General Assembly may allow for a reduction in contract worker hours in conjunction with a budget balancing measure for some professional and non-professional service contracts. If under such authority the agency is required by Executive Order or otherwise to reduce contract hours, the contract will be reduced by the amount specified in that document.

Access to Records:

The vendor, as defined in KRS 45A.030 (9) agrees that the contracting agency, the Finance and Administration Cabinet, the Auditor of Public Accounts, and the Legislative Research Commission, or their duly authorized representatives, shall have access to any books, documents, papers, records, or other evidence, which are directly pertinent to this contract for the purpose of financial audit or program review. Records and other prequalification information confidentially disclosed as part of the bid process shall not be deemed as directly pertinent to the contract and shall be exempt from discloser as provided in KRS 61.878(1)(c). The vendor also recognizes that any books, documents, papers, records, or other evidence, received during a financial audit or program review shall be subject to the Kentucky Open Records Act. KRS 61.870 to 61.884.

Renewal Clause:

The awarded contract may be extended at the completion of the initial contract period for an additional one (1) year period from 07/01/2021 to 06/30/2022. The extension must have the written approval of the vendor and the agency.

Discrimination:

Discrimination (because of race, religion, color, national origin, sex, sexual orientation, gender identity, age, or disability) is prohibited. This section applies only to contracts utilizing federal funds, in whole or in part. During the performance of this contract, the vendor agrees as follows.

1. The vendor will not discriminate against any employee or applicant for employment because of race, religion, color, national origin, sex, sexual orientation, gender identity, or age. The vendor further agrees to comply with the provisions of the Americans with Disabilities Act (ADA), Public Law 101-336, and applicable federal regulations relating thereto prohibiting discrimination against otherwise qualified disabled individuals under any program or activity. The vendor agrees to provide, upon request, needed reasonable accommodations. The contractor will take affirmative action to ensure that applicants are employed and that employees are treated during employment without regard to their race, religion, color, national origin, sex, sexual orientation, gender identity, age or disability. Such action shall include, but not be limited to the following; employment, upgrading, demotion or transfer;

recruitment or recruitment advertising; layoff or termination; rates of pay or other

Document Description Page 7 forms of compensations; and selection for trainings, including apprenticeship. The vendor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this non-discrimination clause.

2. The vendor will, in all solicitations or advertisements for employees placed by or on behalf of the vendor, state that all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age or disability.

3. The vendor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice advising the said labor union or workers’ representative of the contractor’s commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. The vendor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance.

4. The vendor will comply with all provisions of Executive Order No. 11246 of September 26, 1965, as amended, and of the rules, regulations and relevant orders of the Secretary of Labor.

5. The vendor will furnish all information and reports required by Executive Order No.

11246 of September 24, 1965, as amended, and by the rules, regulations and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records and accounts by the administering agency and the Secretary of Labor for the purposes of investigation to ascertain compliance with such rules, regulations and orders.

6. In the event of the contractor’s noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations or orders, this contract may be cancelled, terminated or suspended in whole or in part and the vendor may be declared ineligible for further government contracts or federally-assisted construction contracts in accordance with procedures authorized in Executive Order No. 11246 of September 24, 1965, as amended, and such other sanctions may be imposed and remedies invoked as provided in or as otherwise provided by law.

7. The vendor will include provisions of paragraphs (1) through (7) of section 202 of Executive Order 11246 in every subcontract or purchase order unless exempted by rules, regulations or orders of the Secretary of Labor, issued pursuant to section 204 of Executive Order No. 11246 of September 24, 1965, as amended, so that such provisions will be binding upon each subcontractor vendor. The vendor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions including sanctions for noncompliance; provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the agency, the vendor may request the United States to enter into such litigation to protect the interests of the United States.

Background/Drug Testing:

Upon request, vendor’s staff providing services in an EEC facility must pass and/or meet the following:

1. Drug Test: If requested must pass a drug test within 30 days of request. Drug test must include a minimum 10 panel drug test that includes a least Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Marijuana, Methadone, Opiates, Phencyclidine, and Propoxyphene.

2. Criminal Background Screening: Minimum level background check can be requested at any time during the contract of any employee working for the vendor.

Required is social security number validation, state and county criminal back ground check and national database search including sexual offender database for the last 10 years or back to age 18 where legally permissible.

3. Background/Drug Testing is the financial responsibility of the vendor, and will not incur any additional cost to the Commonwealth.

Document Description Page 8

Best Value Criteria for Evaluation

Method of Award:

Award will be made to the best evaluated responsive, responsible best value offeror. The agency will issue a notification of award accepting the best value offer. Prompt Payment may be considered in award criteria.

The Commonwealth intends to award a contract to the vendor, whose offer, conforming to the solicitation, is the most advantageous on the basis of “best value” for all products, services and requirements contained herein. An agency evaluation committee, or a designated individual, will evaluate the information provided by the vendor(s) in response to the established measureable criteria contained in the solicitation. With the ranking approach, price is one of the measureable criteria components of the solicitation. The measurable criteria are added together to determine the vendor’s total score. The vendor with the highest score has the highest ranking. Award is made to the vendor with the highest ranking. If there is only one best value response to the solicitation, the evaluation process may be waived and the award may be made to the only responsive, responsible vendor.

Measureable Criteria:

Price 80 Points

Vendor Experience-Years in Service 20 Points

Vendor Letter of Reference: Pass/Fail Must provide one (1) letter of reference with valid contact information.

Price (80 Points) – The bidder with the lowest price receives the maximum score. The bidder with the next lowest price receives points by dividing the lowest price by the next lowest price and multiplying that percentage by the available points. For example, assume bidder A has a low bid at $100,000 then he would receive 80 points ($100,000/100,000=1.00 x 80=80). Assume $110,000 is the next lowest offer by bidder B, then he receives 72.7 points (100,000/$110,000=0.91 x 80=72.7).

Vendor Experience (20 Points) – The vendor with the greatest number of years’ experience in janitorial services (a minimum 2 years is required and for evaluation purposes a maximum of 15) receives the maximum points. Assume vendor A has 25 years’ experience in janitorial services, then he received 20 points (20/20=1.00 x 20=20). Assume vendor B has 10 years janitorial service experience, then he receives 10 points (10/20=.5 x 20=10).

Vendor Letter of Reference (Pass/Fail) – The vendor must provide at least one (1) letter of reference from a recent or current customer (within the last 12 months). The letter needs to include a contact person’s name, phone number, and/or email address along with a signature. If no reference letter is provided the vendor will be deemed non-responsive.

Best Value scoring is subject to Reciprocal Preference for Kentucky resident bidders and Preferences for a Qualified Bidder or the Department of Corrections, Division of Prison Industries (KAR 200 5:410).

KRS 45A.490 Definitions for KRS 45A.490 to 45A.494.

As used in KRS 45A.490 to 45A.494:

(1) “Contract” means any agreement of a public agency, including grants and orders, for the purchase or disposal of supplies services, construction, or any other item; and

(2) “Public” agency has the same meaning as in KRS 61.805.

KRS 45A.492 Legislative Declarations.

The General Assembly declares:

(1) A Public purpose of the Commonwealth is serviced by providing preference to Kentucky residents in contracts by public agencies; and

(2) Providing preference to Kentucky residents equalizes the competition with other states that provide preference to their residents.

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KRS 45A.494 Reciprocal preference to be given by the public agencies to resident bidders – List of states – Administrative regulations.

(1) Prior to a contract being awarded to the lowest responsible and responsive bidder on a contract by a public agency, a resident bidder of the Commonwealth shall be given a preference against a nonresident bidder registered in any state that gives or requires a preference to bidders from that state. The preference shall be equal to the preference given or required by the state of the nonresident bidder.

(2) A resident bidder 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:

(a) Is authorized to transact business in the Commonwealth; and

(b) Has for one (1) year prior to and through the date of the advertisement, filed Kentucky corporate income taxes, made payments to the Kentucky unemployment insurance fund established in KRS 341.490, and maintained a Kentucky Workers’ Compensation policy in effect.

(3) A nonresident bidder is an individual, partnership, association, corporation, or other business entity that does not meet the requirements of subsection (2) of this section.

(4) If a procurement determination results in a tie between a resident bidder and a nonresident bidder, preference shall be given to the resident bidder.

(5) This section shall apply to all contracts funded or controlled in whole or in part by a public agency.

(6) The Finance and Administration Cabinet shall maintain a list of states that give to or require a preference for their own resident bidders, including details of the preference given to such bidders, to be used by the public agencies in determining resident bidder preferences. The Cabinet shall also promulgate administrative regulations in accordance with KRS Chapter 13A establishing the procedure by which the preferences required by this section shall be given.

(7) The preference for resident bidders shall not be given if the preference conflicts with federal law.

(8) Any public agency soliciting or advertising for bids for contracts shall make KRS 45A.490 to 45A.494 part of the solicitation or advertisement for bids.

The reciprocal preference as described in KRS 45A.490-494 above shall be applied in accordance with 200 KAR 5:400.

Determining the residency of a bidder for purposes of applying a reciprocal preference:

Any individual, partnership, association, corporation, or other business entity claiming resident bidder status shall submit along with its response, the attached Required Affidavit for Bidders, Offerors, and Contractors Claiming Resident Bidder Status. 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.

A nonresident bidder shall submit, along with its response, its certificate of authority to transact business in the Commonwealth as filed with the Commonwealth of Kentucky, Secretary of State. The location of the principal office identified therein shall be deemed the state of residency for that bidder.

If the bidder is not required by law to obtain said certificate, the state of residency for that bidder shall be deemed to be that which is identified in its mailing address as provided in its bid.

Preferences for a Qualified Bidder or the Department of Corrections, Division of Prison Industries (KAR 200 5:410).

Pursuant to 200 KAR 5:410, and KRS 45A.470, Kentucky Correctional Industries will receive a preference equal to twenty (20) percent of the maximum points awarded to a bidder in a solicitation.

In addition, the following “qualified bidders” will receive a preference equal to fifteen (15) percent of the maximum points awarded to a bidder in a solicitation: Kentucky Industries for the Blind, any nonprofit corporation that furthers the purpose of KRS Chapter 163 and any qualified nonprofit agencies for individuals with severe disabilities as defined in KRS 45A.465(3). Other than Kentucky Industries for the Blind, a bidder claiming “qualified bidder” status shall submit along with its response

Document Description Page 10 to the solicitation a notarized affidavit which affirms that it meets the requirements to be considered a qualified bidder – affidavit form included. If requested, failure to provide documentation to a public agency proving qualified bidder status may result in a disqualification of the bidder or contract termination.

Past Vendor Performance may be considered in the award of this contract. Vendors with a record of poor performance in the last twelve (12) months may be found non-responsive and ineligible for award.

Please Note:

The following Contractor Information Form and the Required Affidavit for Bidders, Offerors and Contractors Forms must be completed and returned with your proposal. Failure to do so may result in your proposal being disqualified.

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Document Description Page 12

Document Description Page 13 http://www.lrc.state.ky.us/kar/200/005/410reg.htm

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Affidavit Effective Date:

Affidavit Expiration Date:

Maximum Length One-Year

REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS PAGE 1 OF 2

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 under penalty of perjury that the entity bidding, is not currently engaged in, and will not for the duration of the contract engage in, the boycott of a person or an entity based in or doing business with a jurisdiction with which Kentucky can enjoy open trade, as defined in Executive Order No. 2018-905.

f. 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) years, 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

Document Description Page 15

2000000157 RFQ Janitorial Services-Pineville Branch Office 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 of the gubernatorial slate elected in the election last preceding the date of contract award.

REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS PAGE 2 OF 2

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, offeror, or contractor becomes non-compliant with any statements 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 16 http://www.lrc.ky.gov/KRS/121-00/330.PDF http://www.lrc.ky.gov/KRS/121-00/330.PDF