h. Qualified 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 Qualified Bidder Affidavit document for RFB 758 1900000315 issued by a Kentucky state or local bidding agency. The affidavit is a required submission for all bidders and offerors claiming qualified bidder status under 200 KAR 5:410(3). Bidders must swear under penalty of perjury that both the bidding entity and all subcontractors meet the requirements to be considered a qualified bidder and will maintain compliance throughout the contract term. The document allows bidders to identify which qualified bidder status applies to their entity, including nonprofit corporations furthering the purposes of KRS Chapter 163 or qualified nonprofit agencies for individuals with severe disabilities as defined under KRS 45A.465(3).
To qualify as a nonprofit agency for individuals with severe disabilities, an organization must be organized and operated in the interest of individuals with severe disabilities, comply with applicable occupational health and safety laws of the United States and Kentucky, employ individuals with severe disabilities for no less than seventy-five percent of direct labor man hours in the manufacture or provision of products or services listed under KRS 45A.470, and be registered in good standing as a nonprofit organization with the Kentucky Secretary of State. The bidding agency reserves the right to request documentation supporting any claimed qualified bidder status, and failure to provide requested documentation upon demand may result in bidder disqualification or contract termination. The affidavit must be notarized and include the signature, printed name, title, date, and company information of the authorized representative.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attach A - 4 758 1900000315.pdf | ||
| g. Resident Bidder Affidavit.doc | DOC document | |
| c. BID QUOTATION FORM.docx | DOCX document | |
| KTRS Questions and Response.pdf | ||
| SAMPLE POLICY KTRS 2017-2018.pdf | ||
| 2017-2018 Fiduciary Liability Insurance Application.pdf | ||
| a. KTRS Detailed Requirements.docx | DOCX document | |
| d. BID ENHANCEMENT FORM.docx | DOCX document | |
| Final_RFB_758_1900000315_4_SO_FORM.PDF | ||
| Final_RFB_758_1900000315_3_SO_FORM.PDF | ||
| e. BID DEVIATION FORM.docx | DOCX document | |
| Final_RFB_758_1900000315_1_SO_FORM.PDF | ||
| F. Bidder Affidavit.pdf | ||
| B. BIDDER INFORMATION FORM.docx | DOCX document | |
| KTRS Loss Run.pdf | ||
| Attach A - 2 758 1900000315.pdf |
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Text version
Solicitation/Contract #: RFB 758 1900000315 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:
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