J02P5600011_MercuryAffidavit.pdf
PDF 76 KB Posted
- Attached to
- NetApp HW Renewal
- Solicitation number
- BPM046181
- Issued by
- Baltimore County, Maryland
About this file
This document is a Mercury Affidavit attachment that is required as part of a state and local government contract opportunity. The affidavit must be completed by the authorized representative of the business submitting a bid or proposal, affirming whether the offered product(s) contain mercury or not. The affidavit acknowledges that it may be distributed to various government entities, including the State of Maryland, its counties and subdivisions, other states, and the federal government. The affidavit also states that its contents are subject to applicable laws, and that nothing in the affidavit or resulting contract shall supersede the government's statutory rights and remedies.
The affidavit requires the business to either state that the offered product(s) do not contain mercury, or to describe the product component that contains mercury and provide the amount of mercury present. The authorized representative must sign the affidavit under the penalties of perjury, attesting to the truthfulness and correctness of the information provided to the best of their knowledge.
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Other files
| File | Type | Posted |
|---|---|---|
| updated_J02P5600011_NetApp_HW_Renewal_Hardware_PORFP_.docx | DOCX document | |
| J02P5600011_NetApp_HW_Renewal_Bid_Form.xlsx | XLSX spreadsheet |
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Text version
ATTACHMENT H – 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
ATTACHMENT H – Mercury Affidavit
File details come from the government source that posted it. Updated .