SP270011 Attachment-J.-Mercury-Affidavit.pdf
PDF 99 KB Posted
- Attached to
- Purchase 13-inch MacBook Air & Accessories
- Solicitation number
- BPM059094
- Issued by
- Maryland
About this file
This is a Mercury Affidavit form required by the State of Maryland for a procurement of 13-inch MacBook Air computers and accessories. The affidavit must be completed and submitted by the authorized representative of any bidding business as part of the bid or proposal package. The form requires the affiant to declare under penalty of perjury whether the products being offered contain mercury, and if they do, to provide detailed information about which product components contain mercury and the specific quantities involved, including units of measure.
The completed affidavit will be distributed to the State of Maryland, its counties and subdivisions, other states, and the federal government. All responses are subject to applicable criminal and civil laws of the United States and Maryland. Misrepresentations or violations of the obligations, terms, covenants, or conditions outlined in the affidavit, the resulting contract, or other related affidavits may result in legal action. The affidavit must be signed and dated by the authorized business representative and submitted with the bid proposal package as Attachment J, with Attachment K serving as a duplicate copy for record-keeping purposes.
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Text version
Attachment J – Mercury Affidavit Effective Date: July 2024
Attachment J. Mercury Affidavit
AUTHORIZED REPRESENTATIVE THEREBY AFFIRM THAT:
I, _______________________________ (name of affiant) am the _______________________________ (title) and the duly authorized representative of _______________________________ (name of the 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.
� In an attachment to this Mercury Affidavit:
(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 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
SUBMIT THIS AFFIDAVIT WITH BID/PROPOSAL
Attachment J. Mercury Affidavit needs to be returned with Bid Proposal Package
Attachment K. Mercury Affidavit
File details come from the government source that posted it. Updated .