g. Resident Bidder Affidavit.doc
DOC document 35 KB Posted
- Attached to
- FIDUCIARY LIABILTY INSURANCE
- Solicitation number
- RFB 758 1900000315 4
- Issued by
- Elliott County, Kentucky
About this file
This is a Required Affidavit for Resident Bidder Status document associated with Solicitation/Contract RFB 758 1900000315. The affidavit establishes the criteria and requirements for bidders, offerors, and contractors seeking to claim resident bidder status in the Commonwealth of Kentucky. Bidders must certify under penalty of perjury that their entity is authorized to transact business in Kentucky and has maintained compliance with state requirements for a minimum of one year prior to and through the date of contract advertisement. Compliance requirements include filing Kentucky income taxes, making payments to the Kentucky unemployment insurance fund, and maintaining an active Kentucky workers' compensation policy.
The bidding agency retains the right to request documentation supporting any claim of resident bidder status. Failure to provide such supporting documentation upon request will result in automatic disqualification of the bidder or termination of the contract if awarded. The affidavit requires execution by the bidder with signature, printed name, title, and date, along with company name and address. The document must be notarized, with the notary public providing their seal and commission expiration date.
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Other files
| File | Type | Posted |
|---|---|---|
| Attach A - 4 758 1900000315.pdf | ||
| a. KTRS Detailed Requirements.docx | DOCX document | |
| F. Bidder Affidavit.pdf | ||
| KTRS Questions and Response.pdf | ||
| SAMPLE POLICY KTRS 2017-2018.pdf | ||
| c. BID QUOTATION FORM.docx | DOCX document | |
| Final_RFB_758_1900000315_4_SO_FORM.PDF | ||
| 2017-2018 Fiduciary Liability Insurance Application.pdf | ||
| h. Qualified Bidder Affidavit.doc | DOC document | |
| d. BID ENHANCEMENT FORM.docx | DOCX document | |
| KTRS Loss Run.pdf | ||
| Attach A - 2 758 1900000315.pdf | ||
| B. BIDDER INFORMATION FORM.docx | DOCX document | |
| Final_RFB_758_1900000315_1_SO_FORM.PDF | ||
| e. BID DEVIATION FORM.docx | DOCX document | |
| Final_RFB_758_1900000315_3_SO_FORM.PDF |
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Text version
Solicitation/Contract #: RFB 758 1900000315 REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS CLAIMING RESIDENT BIDDER STATUS
FOR BIDS AND CONTRACTS IN GENERAL:
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.
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:
File details come from the government source that posted it. Updated .