FORM 3 RFP - AffidavitforQualifiedBidderStatus.xml

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: Normal 0 1 293 1676 Microsoft Office Word 0 13 3 false Title 1 FY19 Affidavit for Qualified Bidder Status Commonwealth of Kentucky false 1966 false false 16.0000 FY19 Affidavit for Qualified Bidder Status Commonwealth Office of Technology Petrey, Vanessa L (CHFS OATS DPSGO) 2 2018-10-01T18:15:00Z 2018-10-01T18:15:00Z Boilerplates Contracts RFP Affidavit #3 Contract Oversight 4800.00000000000 Boilerplates Contracts Contract Oversight RFP Affidavit #3