Final_RFQ_540_2300000147_1_SO_FORM.PDF

Document ID: RFQ 540 2300000147 Page: 1

Commonwealth of Kentucky

SOLICITATION

Modification: No Version #:

TITLE: Greenup Co Glowforge

Date Issued:

03/20/2023 Record Date:

03/17/2023

Solicitation Closes Date:

03/27/2023 Time:

14:30

Solicitation No:

RFQ 540 2300000147

Online Bidding Prohibited: Yes For Information Call:

Allison Sadler 502-564-1979

Bid Receiving Location:

Bid Receiving

See Terms & Conditions for Bid Submission Instructions

Other KY

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 540 2300000147 Page: 2

Line Items

Commodity Group: Default

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

1 Groforge Pro, Standard 1.00000 EA

Comm Code Comm Description Manufacturer Model # Manuf Part #

204 COMPUTER HARDWARE AND

PERIPHERALS FOR MICROCOMPUTERS

Extended Description Glowforge Pro, Standard Material Capability 19.5" by 11" (Glowforge Basic and Plus) 19.5" by (Glowforge Pro) Maximum material height: 2" (50mm)

Software Drag-and-drop with live camera preview Works with Mac, PC, iPhone, Android, and more JPG, PNG, SVG, PDF, and more

Hardware Dimensions: 38W x 20.75D x 8.25H Dual cameras: wide angle & macro Precise to 1/1000th of an inch Full autofocus

Glowforge Accessory Kit

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

2 EDU Premium 1 Year Plan 1.00000 EA

Comm Code Comm Description Manufacturer Model # Manuf Part #

208 COMPUTER SOFTWARE FOR

MICROCOMPUTERS, SYSTEMS,

INCLUDING CLO

Extended Description EDU Premium 1 Year Plan

Shipping Information Area Technology Center - Greenup County Shipping 146 Musketeer Dr

Greenup KY 41144

Billing Information Area Technology Center - Greenup County Billing 146 Musketeer Dr

Greenup KY 41144

Document ID: RFQ 540 2300000147 Page: 3

Submission Checklist

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

Item Price (90 Points) Warranty (5 Points) Delivery (5 Points)

Kentucky Department of Education

300 Sower Boulevard Frankfort, KY 40601

Informal Solicitation for Goods or Non-Professional Service

Please note: Vendors should review and comply with the general bidding requirements listed under “Procurement Laws, Preference, Regulations and Policies” and “Response to Request for quotation” located on the eProcurement Web page at http://eprocurement.ky.gov and https:// finance.ky.gov/eProcurement/Pages/doing-business-with-the-commonwealth.aspx respectively. The vendor must comply with all applicable statutes, regulations and policies related to this procurement.

Solicitation Instructions Due Date for Response 2:30 PM EST March 27, 2023

Request for Quotation must be returned to the following Allison Sadler Allison.Sadler@education.ky.gov

Terms and Conditions

DELIVERY LOCATION

Greenup County Area Technology Center 146 Musketeer Drive Greenup, KY 41144

(606) 473-9344 Stacey Thompson, Principal Danielle Blankenship, Administrative Specialist

DELIVERY/INSTALLATION COMPLETION DATE

Delivery is required before June 15th, 2023

Pricing should include all shipping/delivery and installation and training costs.

GOODS and/or SERVICES TO BE PROVIDED BY VENDOR

Quantity 1 – Glowforge Pro, Standard

Material Capability 19.5" by 11" (Glowforge Basic and Plus) 19.5" by ∞ (Glowforge Pro) Maximum material height: 2" (50mm)

Software Drag-and-drop with live camera preview Works with Mac, PC, iPhone, Android, and more JPG, PNG, SVG, PDF, and more

Hardware Dimensions: 38W x 20.75D x 8.25H Dual cameras: wide angle & macro Precise to 1/1000th of an inch Full autofocus

Glowforge Accessory Kit

Document Description Page 4

2300000147 Greenup Co Glowforge http://eprocurement.ky.gov https://finance.ky.gov/eProcurement/Pages/doing-business-with-the-commonwealth.aspx https://finance.ky.gov/eProcurement/Pages/doing-business-with-the-commonwealth.aspx

Quantity 1 – EDU Premium 1 Year Plan

Onsite Training Any necessary onsite training and certification required for operation.

TOTAL COST, including training, and shipping/handling $_______________

WARRANTY

Minimum one-year warranty on all parts and labor.

EXCEPTIONS TO SPECIFICATIONS

Vendors are cautioned that changes made to the solicitation other than in the designated fields for response shall render the response invalid and result in a non-responsive bid. Otherwise, it will be considered that items/services offered are in strict compliance with these specifications, and the successful bidder shall be held responsible for delivering materials/services that meet these specifications. Any exceptions shall be marked as such within the body of the bid and explained on a separate page. The Commonwealth is not bound to accept any exceptions.

ALTERNATE BRANDS/SPECIFICATIONS

Unless otherwise specified, brands and specifications referenced in this solicitation are meant to establish a minimum standard of quality only. Bidders may bid brands/specifications they consider to be equal by specifying the brand(s)/specifications and inserting the brand name(s), model number(s), etc. on which they are bidding. Bids offering “equal” products/specifications will be considered for award if such products are clearly identified in the bid and are determined by the Commonwealth to meet or exceed fully the minimum essential specifications and salient characteristics referenced in the Solicitation. Bids that contain products/ specifications that fail to meet the minimum essential requirements shall be deemed non-responsive.

Bidders who propose alternate brands/specifications should enclose descriptive literature with their bids so that the equality can be verified. Failure to enclose sufficient literature may result in a non-responsive bid.

If the brands are not changed, the contract will be written accordingly, and the successful bidder shall be required to deliver the brands/specifications stated in the solicitation.

RECYCLE REQUIREMENTS

Prospective bidders are required to comply with Recycle Requirements for the purchase of goods, supplies, equipment, materials, and printing with a minimum recycled content to the extent practicable per 200 KAR 5:330.

INVOICING INSTRUCTIONS

The vendor is responsible to submit an invoice to the agency at the address indicated above on or before the 10th of the month following the month in which the service(s) were rendered. Invoices shall contain, at a minimum, the following information: Contract and order number (if any), item numbers, description of supplies or services, sizes, quantities, unit prices, and extended totals.

PAYMENT TERMS

The vendor shall be paid, upon the submission of proper invoices to the receiving agency at the prices stipulated for the supplies delivered and accepted, or services rendered. Unless otherwise specified, payment will not be made for partial deliveries accepted. Payments will be made within thirty (30) working days after receipt of goods or a vendor’s accurate invoice in accordance with KRS 45.453 and KRS 45.454.

KENTUCKY SALES AND USE TAXES

Sales of tangible personal property or services to the State of Kentucky and its agencies are not subject to state sales or use taxes. The agency shall furnish the tax exemption number for applicable tax-exempt purchases.

GOVERNMENTAL MANDATES (WORKMAN’S COMPENSATION, UNEMPLOYMENT INSURANCE,

ETC)

All services performed under this contract, if applicable, shall be in accordance with the terms and provisions of the contract. The relationship between the State and the Contractor is that of client and independent contractor. No agent, employee, or servant of the contractor or any of its subcontractors shall be or shall be deemed to be an employee, agent, or servant of the State for any reason. The contractor will be solely and entirely responsible for its acts and the acts of its agents, employees, servants and subcontractors during the performance of this contract.

Document Description Page 5

COMPLIANCE WITH STATE LAWS

Contracts and orders shall be governed by the laws of the Commonwealth of Kentucky. The rights and obligations of the parties thereto shall be determined in accordance with these laws.

GOVERNING LAW

This contract shall be governed by and construed in accordance with the laws of the Commonwealth of Kentucky. Any action brought against the Commonwealth on the contract, including but not limited to actions either for breach of contract or for enforcement of the contract, shall be brought in Franklin Circuit Court, Franklin County, Kentucky in accordance with KRS 45A.245

CONTRACT MODIFICATIONS

No modification to this contract shall be permitted unless the contractor receives written approval from the Commonwealth of Kentucky.

If the contractor believes modifications are necessary, the Contractor may request approval of the Commonwealth of Kentucky. All contract modifications shall be subject to the provisions of 200 KAR 5:311.

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, modifications will not result in expenditures against this contract exceeding $20,000 per fiscal year.

TERMINATION OF CONTRACT

This Contract shall be subject to the termination provisions set forth in 200 KAR 5:312.

METHOD OF AWARD

Award will be made to the vendor, whose offer, conforming to the request for quotation, is the most advantageous on the basis of "best value" for all products, services, and requirements contained herein. The agency will issue a notification of award accepting the best value offer. Prompt Payment may be considered in award criteria. The scoring of bids/proposals is subject to Reciprocal preference for Kentucky resident bidders and Preferences for a Qualified Bidder or the Department of Corrections, Division of Prison Industries. See below.

ACCESS TO RECORDS

The state agency certifies that it is in compliance with the provisions of KRS 45A.695, "Access to contractor's books, documents, papers, records, or other evidence directly pertinent to the contract." The Contractor, as defined in KRS 45A.030, 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 agreement for the purpose of financial audit or program review. The Contractor 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. Records and other prequalification information confidentially disclosed as part of the bid process shall not be deemed as directly pertinent to the agreement and shall be exempt from disclosure as provided in KRS 61.878(1)(c).

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 contractor agrees as follows:

1. The contractor 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 contractor 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 contractor 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 forms of compensations; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this non-discrimination clause.

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2. The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, 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 contractor 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 contractor 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 contractor will comply with all provisions of Executive Order No. 11246 of September 24, 1965 as amended, and of the rules, regulations and relevant orders of the Secretary of Labor.

5. The contractor 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 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 contractor 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 contractor will include the 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 or vendor. The contractor 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 contractor may request the United States to enter into such litigation to protect the interests of the United States.

VALIDITY OF OFFER

This offer is valid for sixty (60) days.

Method of Award Best Value - Ranking Approach

The Commonwealth intends to award a contract to the vendor, whose offer, conforming to the request for quotation, is the most advantageous on the basis of "best value" for all products, services, and requirements contained herein.

An evaluation committee, or a designated individual, will evaluate the information provided by the vendor in response to the established measurable criteria contained in the request for quotation.

Measurable Criteria:

Cost 90 Points Warranty 5 Points Delivery 5 Points Total Points 100 Points

Each vendor is responsible for submitting all relevant, factual and correct information with their offer to enable the evaluator(s) to afford each vendor the maximum score based on the available data submitted by the Vendor.

If adequate space is not available, the vendor must attach additional information that clearly cross-references the appropriate location in the request for quotation (i.e. page number, paragraph, subject, etc.).

Document Description Page 7

A bidder shall submit one (1) response to a request for quotation and shall not propose more than one (1) model/brand for each item listed in the request for quotation, except for requested tier pricing. Multiple or alternate bids offering more than one (1) bid price in total or by line item shall be rejected.

Vendors responding with the minimum Best Value requirements in this request for quotation shall not be credited with Best Value points. Vendors responding with greater than the minimum requirements shall receive Best Value points. Failure to provide adequate information will impact the evaluated points awarded to the vendor.

COST; maximum 90 points The bidder with the lowest Cost receives the maximum score. The bidder with the next lowest Cost receives points by dividing the lowest Cost by the next lowest cost and multiplying that percentage by the available points. For example, 90 points is allocated to the lowest Cost criteria for this procurement, bidder “A” bids $3.00 as the lowest bidder and receives the maximum 90 points ($3.00 / $3.00 = 1.00 x 90 = 90). Assume bidder “B” is the next lowest bidder at $4.00, then “B” receives 67.5 points ($3.00 / $4.00) = .75 x 90 = 67.5).

WARRANTY; maximum 5 points

BIDDERS ARE TO ENTER THEIR WARRANTY PERIOD IN MONTHS IN THE SPACE PROVIDED

BELOW.

The bidder shall clearly state the warranty for this procurement. The warranty period must be specific and such phrases as, "as required", "as soon as possible", or "prompt" have no meaning and may result in a non-responsive bid.

Vendor shall enter best materials, workmanship & installation warranty period: __________ MONTHS

For example, if the best warranty offer is 24 months, that bidder receives maximum points. If the next best warranty offer is 18 months, that bidder receives 75 points. (18/24 = .75 X 5 = 3.75 points, etc.)

DELIVERY; maximum 5 points

Prompt delivery following placement of order is desired. The bidder with the best delivery offer will receive maximum points. Other offers will be scored by dividing the best offer by the next best offer and multiplying the available points by that resulting percentage.

For example, if the best delivery offer is 20 days, that bidder receives maximum points. If the next best delivery offer is 30 days, that bidder receives 3.3 points. (20/30 = .666666 X 5 = 3.3 points, etc.)

BIDDERS ARE TO ENTER THEIR DELIVERY OFFER IN CALENDAR DAYS IN THE SPACE PROVIDED

BELOW.

The bidder shall clearly state the delivery time for this procurement. Delivery time must be specific and such phrases as, "as required", "as soon as possible", or "prompt" have no meaning and may result in a non-responsive bid.

Vendor should enter best delivery time in calendar days: __________ DAYS ARO

The vendor agrees that when delivery/service is not made within the contracted due date, one percent (1%) per day will be deducted from the vendor’s invoice for each day the vendor fails to meet the contracted delivery/service date.

The Commonwealth reserves the right to negotiate all aspects of the solicitation with the evaluated best-value vendor.

Past Vendor Performance may be considered in the award of this Contract. Vendors with a record of poor performance in the last 12 months may be found non-responsible and ineligible for award.

Successful bidder shall submit an Annual Affidavit for Bidders, Offerors and Contractors prior to issuing an award.

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).

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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 served 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.

KRS 45A.494 Reciprocal preference to be given by 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 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 request for quotation 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 Annual Affidavit for Bidders, Offerors, and Contractors Claiming Resident Bidder Status, unless a valid, Annual Affidavit is already on file with the Commonwealth. 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 request for quotation. 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 request for quotation: Kentucky Industries for the Blind, any nonprofit corporation that furthers the purposes of KRS Chapter 163 and any qualified nonprofit agencies

Document Description Page 9 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 to the request for quotation a notarized annual affidavit, which affirms that it meets the requirements to be considered a qualified bidder- annual affidavit form included. The annual affidavit form is not required if a valid, annual affidavit is already on file with the Commonwealth. If requested, failure to provide documentation to a public agency proving qualified bidder status may result in disqualification of the bidder or contract termination.

Bidder, Offeror, or Contractor Mandatory Representations Compliance with Commonwealth Law The contractor represents that, pursuant to KRS 45A.485, they and any subcontractor performing work under the contract will be in continuous compliance with the KRS chapters listed below and have revealed to the Commonwealth any violation determinations within the previous five (5) years:

KRS Chapter 136 (CORPORATION AND UTILITY TAXES) KRS Chapter 139 (SALES AND USE TAXES) KRS Chapter 141 (INCOME TAXES) KRS Chapter 337 (WAGES AND HOURS) KRS Chapter 338 (OCCUPATIONAL SAFETY AND HEALTH OF EMPLOYEES) KRS Chapter 341 (UNEMPLOYMENT COMPENSATION) KRS Chapter 342 (WORKERS' COMPENSATION)

Boycott Provisions If applicable, the contractor represents that, pursuant to KRS 45A.607, they are 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. Note: The term Boycott does not include actions taken for bona fide business or economic reasons, or actions specifically required by federal or state law.

If applicable, the contractor verifies that, pursuant to KRS 41.480, they do not engage in, and will not for the duration of the contract engage in, in energy company boycotts as defined by KRS 41.472.

Lobbying Prohibitions The contractor represents that they, and any subcontractor performing work under the contract, have not violated the agency restrictions contained in KRS 11A.236 during the previous ten (10) years, and pledges to abide by the restrictions set forth in such statute for the duration of the contract awarded.

The contractor further represents that, pursuant to KRS 45A.328, they have not procured an original, subsequent, or similar contract while employing an executive agency lobbyist who was convicted of a crime related to the original, subsequent, or similar contract within five (5) years of the conviction of the lobbyist.

Document Description Page 10 https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22431 https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=37644 https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=37663 https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=37674 https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38890 https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38899 https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38902 https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38914 https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=48539 https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=50541 https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=52935

Rev. 9-16-22

Required Affidavit for Bidders, Offerors and Contractors

(KRS 45A.110 & 45A.115)

Affidavit Effective for One (1) Year from Date of Execution

Instructions: Pursuant to KRS 45A.110 and 45A.115, a bidder, offeror, or contractor (“Contractor”) is required to submit a Required Affidavit for Bidders, Offerors, and Contractors to be awarded a contract, or for the renewal of a contract. An authorized representative of the contracting party must complete the attestation below, have the attestation notarized, and return the completed affidavit to the Commonwealth.

Attestation

As a duly authorized representative for the Contractor, I swear and affirm under penalty of perjury, that that the Contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that the award of a contract will not violate any provision of the campaign finance laws of the Commonwealth. For purposes of this attestation, "Knowingly" means that the bidder or offeror is aware or should have been aware of the existence of a violation. The bidder or offer understands that the Commonwealth retains the right to request an updated affidavit at any time.

Printed Name

Signature

Date

Title

Bidder or Offeror Name: __________________________________________________________

Address: __________________________________________________________

Commonwealth of Kentucky Vendor Code (If known): _______________

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Rev. 9-16-22

Subscribed and sworn to before me this _____ day of _______________, ____________.

State of: ___________________ Notary: ___________________________________

County of: _________________ My Commission Expires: _____________________

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REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS CLAIMING QUALIFIED

BIDDER STATUS

FOR BIDS AND CONTRACTS IN GENERAL:

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.

Signature Printed Name

Title Date Company Name Address

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

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