Hardware 2012 Contract Mercury Affidavit.pdf
PDF 46 KB Posted
- Attached to
- FC0001985 - NWM Ciena 3948 Sparing Replenishment
- Solicitation number
- BPM055931
- Issued by
- Maryland
About this file
This is a Mercury Affidavit form for the Hardware 2012 Contract, a procurement requirement of the State of Maryland. The affidavit serves as a disclosure document requiring authorized representatives of bidding businesses to certify whether products offered contain mercury. Bidders must indicate whether their product offerings contain no mercury or identify specific product components that contain mercury, including the quantity and unit of measure for any mercury content present.
The affidavit is subject to the laws of the United States and the State of Maryland and may be distributed to state units, Maryland counties and subdivisions, other states, and the federal government. The authorized representative executing the affidavit must possess legal authority to bind the business and affirms under penalty of perjury that all information provided is true and correct. The submission of this affidavit protects the State of Maryland and its jurisdictional units in their exercise of statutory rights and remedies regarding any misrepresentation or breach of contract obligations by the submitting vendor.
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Other files
| File | Type | Posted |
|---|---|---|
| FC0001985 CIENA PORFP .pdf | ||
| REDACTED BOM.pdf |
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Text version
HARDWARE 2012 - Mercury Affidavit
MERCURY AFFIDAVIT
AUTHORIZED REPRESENTATIVE THEREBY AFFIRM THAT:
I am the _________________ (Title) and the duly authorized representative of _______________________ (Business). I possess the legal authority to make this affidavit on behalf of myself and the business for which I am acting.
MERCURY CONTENT INFORMATION:
[ ] The product(s) offered do not contain mercury.
OR
[ ] The product(s) offered do contain mercury.
(1) Describe the product or product component that contains mercury.
(2) Provide the amount of mercury that is contained in the product or product component. Indicate the unit of measure being used.
I ACKNOWLEDGE THAT this affidavit is to be furnished to the procurement officer and may be distributed to units of (1) the State of Maryland; (2) counties or other subdivisions of the State of Maryland;
(3) other states; and
(4) the federal government. I further acknowledge that this Affidavit is subject to applicable laws of the United States and the State of Maryland, both criminal and civil, and that nothing in this affidavit or any contract resulting from the submission of this bid or proposal shall be construed to supersede, amend, modify, or waive, on behalf of the State of Maryland, or any unit of the State of Maryland having jurisdiction, the exercise of any statutory right or remedy conferred by the Constitution and the laws of Maryland with respect to any misrepresentation made or any violation of the obligations, terms and covenants undertaken by the above business with respect to (1) this affidavit, (2) the contract, and (3) other affidavits comprising part of the contract.
I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT
THE CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE, INFORMATION, AND BELIEF.
________________ By: ___________________________ Date Signature
Print Name: _____________________________________ Authorized Representative and Affiant
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