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 Solicitation/Contract #RFB 758 1900000315, issued by a state bidding agency in Kentucky under the authority of 200 KAR 5:410(3). The affidavit serves as a required declaration for bidders and offerors claiming qualified bidder status, establishing their eligibility to participate in state and local contracting opportunities. Bidders must affirm under penalty of perjury that they and all subcontractors meet the specified qualified bidder requirements and will maintain compliance throughout any awarded contract term.
The document identifies two primary categories of qualified bidder status: nonprofit corporations that further the purposes of Kentucky Revised Statutes Chapter 163, and qualified nonprofit agencies for individuals with severe disabilities as defined under KRS 45A.465(3). Organizations claiming the latter status must be organized to serve individuals with severe disabilities, comply with applicable occupational health and safety laws, employ individuals with severe disabilities for at least seventy-five percent of direct labor man hours in manufacturing or providing listed products or services, and maintain registered nonprofit status in good standing with the Secretary of State. The bidding agency reserves the right to request supporting documentation for any qualified bidder status claim, and failure to provide such documentation upon request may result in bidder disqualification or contract termination. The affidavit requires notarization and must be executed by an authorized representative of the bidding entity.
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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 | ||
| d. BID ENHANCEMENT FORM.docx | DOCX document | |
| KTRS Loss Run.pdf | ||
| Attach A - 2 758 1900000315.pdf | ||
| B. BIDDER INFORMATION FORM.docx | DOCX document | |
| g. Resident Bidder Affidavit.doc | DOC 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 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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