BULK ICE CONTROL ROCK SALT/SODIUM CHLORIDE

Similar documents
Storage Cages for the Solid Waste Division of the Boone County Fiscal Court

Prior to 2:00 p.m., DECEMBER 8, 2016 Local time

SEVEN (7), 2017 OR NEWER GASOLINE POWERED, 1 TON 4x4 CREW CAB LONG BED PICKUP TRUCKS For the Boone County Public Works Department

VENDING MACHINE SERVICES FOR THE BOONE COUNTY FISCAL COURT

GASOLINE POWERED, ¾ TON 4X4 EXTENDED CAB WITH LONG BOX PICK-UP TRUCK For the Boone County Parks & Recreation Department

ONE (1), NEW 1 TON CAB CHASSIS AND UTILITY BODY For the Boone County Public Works Department

MDT HARDWARE REFRESH FOR THE PUBLIC SAFETY COMMUNICATIONS CENTER

INVITATION TO BID CHLORINE DIOXIDE GENERATOR FOR HENDERSON WATER UTILITY. HWU website:

DUAL VIEW FULL BODY SCANNER SYSTEM FOR THE BOONE COUNTY JAIL

CITY OF FORT MITCHELL, KENTUCKY INVITATION TO BID FOR DIXIE HIGHWAY REMOVAL AND REPLACEMENT OF STREET TREES

INVITATION FOR BID ATTENTION: This is not an order. Read all instructions, terms and conditions carefully.

INVITATION TO BID. ATTENTION: This is not an order. Read all instructions, terms and conditions carefully.

BID NO Troy School District

University of Louisville PURCHASING DEPARTMENT LOUISVILLE, KENTUCKY

Western Kentucky University Sports Medicine Complex

INVITATION FOR BID SODIUM BISULFITE FOR THE HENDERSON WATER UTILITY. HWU Bobby Gish Administration Building: 111 Fifth Street, Henderson, KY 42420

UNIFORM & MAT RENTAL For the Boone County Fiscal Court

The City of Henderson

Proposal No:

PARTNERS PROJECT IDENTIFICATION PROJECT IDENTIFICATION

REQUEST FOR PROPOSALS For. Guaranteed Energy Savings Contract

REQUEST FOR PROPOSAL (RFP 06-16) WATER SYSTEM ASSESSMENT CITY OF FOLLY BEACH

BULLOCH COUNTY BOARD OF COMMISSIONERS 115 NORTH MAIN STREET STATESBORO, GEORGIA (912)

BID RECEIVING OFFICE: Forsyth County Public Library, Administrative Offices, 585 Dahlonega Street, Cumming, GA 30040

PUBLIC NOTICE LORI FULKS GARVIN COUNTY CLERK

CITY OF MIAMI OKLAHOMA OFFICE OF THE PURCHASING AGENT

CITY OF DAPHNE P.O. BOX MAIN STREET DAPHNE, ALABAMA 36526

Date: Telephone: Company Name: Address: City: State: Zip Code: Contact Person: Title: Cell Phone: Authorized Signature:

INVITATION TO BID COMMERCIAL FLOORING CONTRACTORS

ADVERTISEMENT FOR BIDS

INVITATION TO BID. If you have any questions concerning this bid, you may call Elizabeth Hope at (912)

THE PROVISION OF CRACK SEAL MATERIAL 2017/2018 NOTICE TO BIDDERS. This entire Bid Package, which includes the following:

Motor Grader Packer-Roller. Bids Due and Opening Monday, March 26, 2018 Time: 2:00 p.m.

EASTERN KENTUCKY UNIVERSITY Serving Kentuckians Since Lancaster Avenue CPO 6A-1 Richmond, KY

INVITATION TO BID. ATTENTION: This is not an order. Read all instructions, terms and conditions carefully.

The Minnesota Workers Compensation Assigned Risk Plan (MWCARP) Actuarial Services Request For Proposals

1126 Russell Cave Road Room 137 Lexington, KY 40505

MACON-BIBB COUNTY, GEORGIA

GUILFORD COUNTY SCHOOLS Invitation for Bids

2018 Bulk Magnesium Chloride. Bids Due and Opening Thursday, March 29, 2018 Time: 10:00 a.m.

GUADALUPE COUNTY INVITATION FOR BIDS FLEXIBLE BASE MATERIALS AND ASPHALTIC MATERIALS BID OPENING DATE: 2 PM TUESDAY, DECEMBER 14, 2010

County of Gillespie. Bid Package for GRAVEL. Bid No November 2018

Fayette County Public Schools. Supplier Diversity Program Contract Forms

PLEASANTVILLE HOUSING AUTHORITY

McCracken County Board of Education 435 Berger Road Paducah, KY Mrs. Johnna Lee DeJarnett Assistant Superintendent

THE CITY OF FOREST PARK PLANNING, BUILDING AND ZONING DEPARTMENT JONATHAN JONES, DIRECTOR 785 Forest Parkway Forest Park, GA 30297

NORTHAMPTON AREA SCHOOL DISTRICT REQUEST FOR BIDS

CITY OF GAINESVILLE REQUEST FOR PROPOSAL

BID NO be obtained. must be Rankin. no later. subsequently. addressed or. part; to. make awards. District, Troy, MI 48083

INVITATION TO BID PURCHASING DEPARTMENT P. O. BOX E. CENTRAL AVENUE SECOND FLOOR VALDOSTA, GEORGIA GENESIS EXTRACTION RESCUE TOOLS

LINCOLN PARK BOARD OF EDUCATION REQUEST FOR PROPOSALS FOR ARCHITECTURAL SERVICES

JEFFERSON PARISH SHERIFF S OFFICE INSTRUCTIONS TO BIDDERS AND GENERAL CONDITIONS PUBLIC WORKS/CONSTRUCTION PROJECTS

INSTRUCTIONS TO BIDDERS

City of Spartanburg Procurement and Property Division Post Office Drawer 1749, SC P (864) F (864)

CITY OF MIAMI OKLAHOMA OFFICE OF THE PURCHASING AGENT

GORDON COUNTY BOARD OF COMMISSIONERS INVITATION TO BID Public Works Materials Metal Culverts

CITY OF GALESBURG. PURCHASING 55 W Tompkins St Galesburg, IL Phone: (309)

February 2, Dear Supplier:

FULTON COUNTY, OHIO 703 Aggregate THURSDAY DECEMBER 4, :00 A.M.

SPECIFICATION PACKAGE. for PURCHASE OF SULFURIC ACID WITH TELEMETRY PROGRAM

PREDETERMINATION OF RESPONSIBILITY UNIVERSITY OF PITTSBURGH {SALK HALL RENOVATION PHASE II} DGS PROJECT NO. { }

PURCHASING DEPARTMENT 151 Willowbend Road Peachtree City, GA Phone: Fax:

CITY OF GALESBURG. PURCHASING 55 West Tompkins Street Galesburg, IL Phone: 309/ INVITATION FOR BIDS

PUBLIC NOTICE NOTICE OF REQUEST FOR BIDS CITY OF HIGHWOOD, ILLINOIS ROADWAY SNOW REMOVAL AND SALT APPLICATION

KENTUCKY STATE UNIVERSITY INVITATION FOR BID KSI SURPLUS VEHICLES 2019

INVITATION TO BID. ATTENTION: This is not an order. Read all instructions, terms and conditions carefully.

Part A: PRIME CONTRACTOR PROJECT SUMMARY FORM

County of Gillespie. Bid Package for COLD MIX LAY ASPHALT. Bid No November 2018

Invitation for Bid Specification IFB For Motor Vehicle Storage For CEDA Weatherization. Bid Submitted by

EL PASO COUNTY COMMUNITY COLLEGE DISTRICT POST OFFICE BOX EL PASO, TEXAS GENERAL CONDITIONS OF CONTRACT

TRAVERSE CITY HOUSING COMMISSION REQUEST FOR PROPOSALS FOR ARCHITECTURAL/ENGINEERING SERVICES

Interior Signage, BEP and AS&T Buildings

BULLOCH COUNTY BOARD OF COMMISSIONERS 115 NORTH MAIN STREET STATESBORO, GEORGIA 30458

CITY OF O FALLON, MISSOURI REQUEST FOR PROPOSALS RFP NUMBER DOCUMENT SCANNING. September 15, 2017

INFORMATION FOR BID. Tee Shirts (School Nutrition)

Invitation No.: EKU Eastern Kentucky University 521 Lancaster Avenue Richmond, KY 40475

INVITATION PLEASE REFER TO BID NO TO BID

GUILFORD COUNTY SCHOOLS Invitation for Bids

BID DOCUMENT FOR PURCHASE OF FIVE (5) HP DESIGNJET PLOTTERS MODEL T1500PS 36 OPENING DATE: DECEMBER 19, 2014 TIME: 2:00 P.M.

PROPOSALS MUST BE RECEIVED BY: 10:00 AM (CST) ON FRIDAY, FEBRUARY 1, 2019

REQUEST FOR QUOTATION SUBMIT BID TO PURCHASING DIVISION SHAWNEE COUNTY COURTHOUSE Room 201 Topeka, Kansas THIS IS NOT AN ORDER

One Technology Court, Montgomery, Alabama Telephone: Bid Invitation 874 Maritime Training Center Vending Services

LCRA INVITATION FOR BID LCRA-75 GENERAL REQUIREMENTS

MUST BE SIGNED TO BE VALID

CHEROKEE NATION BUSINESSES, L.L.C. REQUEST FOR PROPOSAL ( RFP ) PROJECT NAME: CNE Ad Agency RFP NUMBER: DATED: TABLE OF CONTENTS

CITY OF GALESBURG. PURCHASING 55 W Tompkins St Galesburg, IL Phone: (309)

BROKEN ARROW PUBLIC SCHOOLS 701 SOUTH MAIN BROKEN ARROW, OK PHONE (918) FAX (918)

BERRIEN COUNTY ROAD DEPARTMENT

Ware County Recreation Department 2110 Cecil Brown Drive Waycross, GA Ph: Fax:

REQUEST FOR PROPOSAL SNOW / ICE REMOVAL HARTLAND CONSOLIDATED SCHOOLS HOWELL, MICHIGAN 48843

LEAF VACUUM CURBSIDE COLLECTION INCLUDING EQUIPMENT AND OPERATOR

Core Technology Services Division PO Box Grand Forks, ND

Request for Proposal for Natural Gas Supply

BID # 455 WASTE REMOVAL

November 8, Dear Supplier:

City of Brentwood, Missouri. Request for Proposals For Ice Rink Water Treatment Service for the Brentwood Recreation Complex.

Bulloch County Board of Commissioners 115 N Main Street Statesboro, GA NOTICE OF SOLICITATION INVITATION TO BID

TOWN OF HARRISON PLANNING BOARD PUBLIC NOTICE FOR SOLICITATION PROFESSIONAL SERVICE CONTRACT JANUARY 1, 2019 THROUGH DECEMBER 31, 2019

ADVERTISEMENT FOR BIDS. Water Plant Backup Generators City of Kearney, MO

REQUEST FOR QUOTATION For CHAIRS FOR THE CHATHAM COUNTY E911 CALL CENTER QUOTE NUMBER:

Transcription:

Boone County, Kentucky INVITATION FOR BID #050516PW BULK ICE CONTROL ROCK SALT/SODIUM CHLORIDE ACCEPTANCE DATE: Prior to 2:00 p.m., May 5, 2016 Local time ACCEPTANCE PLACE Boone County Fiscal Court 2950 Washing Street Office of the Assistant County Administrator 2 nd Floor Administration Building Burling, Kentucky 41005 Requests for information related to this Invitation should be directed to: David Neff Boone County Public Works (859) 334-3600 E-mail address: dneff@boonecountyky.org Issue Date: April 22, 2016 IF YOU NEED ANY REASONABLE ACCOMMODATION FOR ANY TYPE OF DISABILITY IN ORDER TO PARTICIPATE IN THIS PROCUREMENT, PLEASE CONTACT OUR OFFICE AS SOON AS POSSIBLE

INSTRUCTIONS TO BIDDERS & GENERAL CONDITIONS GENERAL BID DESCRIPTION These bid specifications shall be for the purchase of bulk ice control salt/sodium chloride for the City of Florence, Kentucky, Public Services Department and the Boone County, Kentucky, Fiscal Court Public Works Department. Bid prices shall be provided on the bid form for FOB to the City of Florence Public Services Maintenance Facility (exact location provided herein) and price for the City of Florence Public Services Department to pick up from your local facility. Bid prices shall also be provided on the bid form for FOB to the Boone County Fiscal Court Public Works Department (exact location provided herein) and a price for the Boone County Fiscal Court Public Works Department to pick up from your local facility. TERM OF BID The initial term of the bid shall be for an 8-month period. At the expiration of the initial bid period for bulk ice control salt/sodium chloride, three (3) additional one (1) year bid extensions shall be available at the exclusive pleasure of the City of Florence Public Services Department and Boone County Fiscal Court Public Works. DELIVERY LOCATIONS Delivery of salt/sodium chloride to the City of Florence Public Services Department shall be made to the Florence Public Services Maintenance Facility located at 7850 Tanners Lane, Florence, Kentucky, 41042. Delivery of salt/sodium chloride to the Boone County Fiscal Court Public Works Department shall be made to the Boone County Public Works Department located at 5645 Idlewild Road, Burling, KY 41005 (approximately 90% of the nage) and to the Boone County Salt Storage Site located at 2266 Double Eagle Drive, Union, KY 41091 (approximately 10% of the nage). BILLING INSTRUCTIONS Salt/sodium chloride ordered by and delivered to the City of Florence Public Services Department shall be billed to the City of Florence Public Services Department, Attn: Mr. Eric Hall, 8100 Ewing Boulevard, Florence, Kentucky, 41042. Salt/sodium chloride picked up by the City of Florence Public Services

Department shall also be billed to the City of Florence Public Services Department at the same address. Salt/sodium chloride ordered by and delivered to the Boone County Fiscal Court Public Works Department shall be billed to the Boone County Fiscal Court, PO Box 960, Burling, Kentucky 41005. Salt/sodium chloride picked up by the Boone County Fiscal Court Public Works Department shall also be billed to the Boone County Fiscal Court Public Works Department at the same address. MINIMUM TONNAGE REQUESTED The residents of the City of Florence and the residents of Boone County have come to insist upon a certain level of snow removal services. In order to provide these services to the standard of excellence required by the residents, up to a maximum quantity of salt may be needed by each agency. These maximum quantities are outlined below. Each agency reserves the right to purchase up to the maximum quantity but depending on inventory needs, may purchase a lesser amount. The City of Florence Public Services Department and/or the Boone County Fiscal Court Public Works Department are under no obligation to purchase the maximum quantities outlined below. The successful bidder shall make up to the maximum amount available per requirements setforth herein. Bidders who cannot provide the maximum nages listed below shall indicate an alternate amount on the bid form. The maximum salt usage requirements for the City of Florence Public Services Department are 5,000 s. The maximum salt usage requirements for the Boone County Fiscal Court Public Works Department are 15,000 s. SALT DELIVERY REQUIREMENTS Rock salt/sodium chloride shall be delivered to the requested designated location between one (1) to five (5)-calendar days after placement of order. Bidders who cannot provide delivery within the aforementioned time period shall indicate an alternate delivery period on the bid form. SALT SUPPLY BID PERIOD The contract period for purchase of rock salt/sodium chloride under the terms of this bid shall be from September 1, 2016 to May 1, 2017. PAYMENT The City of Florence Public Services Department and the Boone County Fiscal Court Public Works Department will make payment in full within thirty (30) days after receipt of each invoice from the salt supplier.

SUBMITTAL OF BID The Boone County Fiscal Court will received sealed bids in the Office of the Purchasing Agent, Second Floor, Administration Building, 2950 Washing Street, Burling, Kentucky 41005, until 2:00 p.m., May 5, 2016 for bulk ice control salt/sodium chloride for the City of Florence and the Boone County Fiscal Court. Bids will be opened and publicly read aloud at that time in the Fiscal Courtroom, 1 st Floor, Administration Building. Late bids, electronically submitted or facsimile bids will not be accepted. BID ENVELOPE MUST BE LABELED: SEALED BID: SALT/SODIUM CHLORIDE. Specifications may be obtained from the Purchasing Agent located in the Finance Department, Second Floor, Administration Building, 2950 Washing Street, Burling, Kentucky 41005. The Boone County Fiscal Court reserves the right to reject any and all bids, to waive any informality and to negotiate for the modifications of any bid. To accept the bid, which is, deemed the most desirable and advantageous from the standpoint of customer value and service and concept of operations, even though such bid may not, on its face, appear to be the lowest and best price. No bid shall be withdrawn for a period of thirty (30) days after scheduled time of receipt of bids. KENTUCKY PREFERENCE LAW The scoring of bids/proposals is subject to Reciprocal preference for Kentucky resident bidders and Preferences for a Qualified Bidder or the Department of Corrections, Division of Prison Industries. *Vendors not claiming resident bidder or qualified bidder status need not submit the corresponding affidavit. All bidders must fill out the REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS CLAIMING RESIDENT BIDDER STATUS. If this form is not completed and notarized, the bid will not be considered. AWARD OF BID The City of Florence Public Services Department and the Boone County Fiscal Court Public Works Department will award contracts to the lowest and best bidder. Factors considered in bid award may include, but not be limited to price, quantities available, timeliness of delivery, and previous track record in working with each agency.

The City of Florence Public Services Department and the Boone County Fiscal Court Public Works Department reserves the right to award bid to the same supplier, or to a different supplier for each agency. Each agency reserves the right to reject any and all bids. AGENCY CONTACT PERSONS Questions regarding bulk salt delivery, or ordering of bulk salt from the City of Florence Public Services Department should be directed to Mr. Eric Hall, (859) 647-5416. Questions regarding bulk salt delivery, or ordering of bulk salt from the Boone County Fiscal Court Public Works Department should be directed to Mr. David Neff, (859) 334-3600.

BID FORM I, the undersigned, propose to furnish all labor, equipment, and material necessary to supply bulk ice control rock salt/sodium chloride to the City of Florence, Kentucky Public Services Department and the Boone County, Kentucky, Fiscal Court Public Works Department. In submitting this bid, I agree to hold this proposal open for sixty days after the bid date. I further agree to enter into a contract, if selected, on the basis of this proposal within ten (10) days. CITY OF FLORENCE- 5,000 s DESCRIPTION Total Cost Per Ton, Delivered FOB Florence, KY Total Cost Per Ton, Customer Pick Up. INITIAL BID PERIOD 1ST 2ND 3RD Delivery Can Be Expected Days from Receipt of Order.

BOONE COUNTY- 15,000 s DESCRIPTION Total Cost Per Ton, Delivered FOB Burling, KY Total Cost Per Ton, Customer Pick Up. INITIAL BID PERIOD 1ST 2ND 3RD Delivery Can Be Expected Days from Receipt of Order. BIDDER INFORMATION Complete Name of Supplier Authorized Agent of Supplier Signature Complete Address of Supplier Phone # ( ) FAX # ( ) Date Federal ID# BIDDERS 24 HOUR EMERGENCY CONTACT PERSON & PHONE NUMBER Contact Person for Ordering Salt Contact Person Phone Number ( )

KENTUCKY PREFERENCE LAWS The scoring of bids/proposals is subject to Reciprocal preference for Kentucky resident bidders and Preferences for a Qualified Bidder or the Department of Corrections, Division of Prison Industries. *Vendors not claiming resident bidder or qualified bidder status need not submit the corresponding affidavit. Reciprocal preference for Kentucky resident bidders KRS 45A.490 Definitions for KRS 45A.490 to 45A.494. As used in KRS 45A.490 to 45A.494: (1) "Contract" means any agreement of a public agency, including grants and orders, for the purchase or disposal of supplies, services, construction, or any other item; and (2) "Public agency" has the same meaning as in KRS 61.805. KRS 45A.492 Legislative declarations. The General Assembly declares: (1) A public purpose of the Commonwealth is served by providing preference to Kentucky residents in contracts by public agencies; and (2) Providing preference to Kentucky residents equalizes the competition with other states that provide preference to their residents. KRS 45A.494 Reciprocal preference to be given by public agencies to resident bidders -- List of states -- Administrative regulations. (1) Prior to a contract being awarded to the lowest responsible and responsive bidder on a contract by a public agency, a resident bidder of the Commonwealth shall be given a preference against a nonresident bidder registered in any state that gives or requires a preference to bidders from that state. The preference shall be equal to the preference given or required by the state of the nonresident bidder. (2) A resident bidder is an individual, partnership, association, corporation, or other business entity that, on the date the contract is first advertised or announced as available for bidding: (a) Is authorized to transact business in the Commonwealth; and (b) Has for one (1) year prior to and through the date of the advertisement, filed Kentucky corporate income taxes, made payments to the Kentucky unemployment insurance fund established in KRS 341.490, and maintained a Kentucky workers' compensation policy in effect. (3) A nonresident bidder is an individual, partnership, association, corporation, or other business entity that does not meet the requirements of subsection (2) of this section. (4) If a procurement determination results in a tie between a resident bidder and a nonresident bidder, preference shall be given to the resident bidder. (5) This section shall apply to all contracts funded or controlled in whole or in part by a public agency. (6) The Finance and Administration Cabinet shall maintain a list of states that give to or require a preference for their own resident bidders, including details of the preference given to such bidders, to be used by public agencies in determining resident bidder preferences. The cabinet shall also promulgate administrative regulations in accordance

with KRS Chapter 13A establishing the procedure by which the preferences required by this section shall be given. (7) The preference for resident bidders shall not be given if the preference conflicts with federal law. (8) Any public agency soliciting or advertising for bids for contracts shall make KRS 45A.490 to 45A.494 part of the solicitation or advertisement for bids. The reciprocal preference as described in KRS 45A.490-494 above shall be applied in accordance with 200 KAR 5:400. Determining the residency of a bidder for purposes of applying a reciprocal preference Any individual, partnership, association, corporation, or other business entity claiming resident bidder status shall submit along with its response the attached Required Affidavit for Bidders, Offerors, and Contractors Claiming Resident Bidder Status. The BIDDING AGENCY reserves the right to request documentation supporting a bidder s claim of resident bidder status. Failure to provide such documentation upon request shall result in disqualification of the bidder or contract termination. A nonresident bidder shall submit, along with its response, its certificate of authority to transact business in the Commonwealth as filed with the Commonwealth of Kentucky, Secretary of State. The location of the principal office indentified therein shall be deemed the state of residency for that bidder. If the bidder is not required by law to obtain said certificate, the state of residency for that bidder shall be deemed to be that which is identified in its mailing address as provided in its bid. Preferences for a Qualified Bidder or the Department of Corrections, Division of Prison Industries. Pursuant to 200 KAR 5:410, and KRS 45A.470, Kentucky Correctional Industries will receive a preference equal to twenty (20) percent of the maximum points awarded to a bidder in a solicitation. In addition, the following qualified bidders will receive a preference equal to fifteen (15) percent of the maximum points awarded to a bidder in a solicitation: Kentucky Industries for the Blind, any nonprofit corporation that furthers the purposes of KRS Chapter 163 and any qualified nonprofit agencies for individuals with severe disabilities as defined in KRS 45A.465(3). Other than Kentucky Industries for the Blind, a bidder claiming qualified bidder status shall submit along with its response to the solicitation a notarized affidavit which affirms that it meets the requirements to be considered a qualified bidder- affidavit form included. If requested, failure to provide documentation to a public agency proving qualified bidder status may result in disqualification of the bidder or contract termination.

Solicitation/Contract #: 050516PW REQUIRED AFFIDAVIT FOR BIDDERS, OFFERORS AND CONTRACTORS CLAIMING RESIDENT BIDDER STATUS FOR BIDS AND CONTRACTS IN GENERAL: The bidder or offeror hereby swears and affirms under penalty of perjury that, in accordance with KRS 45A.494(2), the entity bidding is an individual, partnership, association, corporation, or other business entity that, on the date the contract is first advertised or announced as available for bidding: 1. Is authorized to transact business in the Commonwealth; 2. Has for one year prior to and through the date of advertisement a. Filed Kentucky income taxes; b. Made payments to the Kentucky unemployment insurance fund established in KRS 341.49; and c. Maintained a Kentucky workers compensation policy in effect. The BIDDING AGENCY reserves the right to request documentation supporting a bidder s claim of resident bidder status. Failure to provide such documentation upon request shall 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 (Company Name) this day of,20. Notary Public [seal of notary] My commission expires:

Solicitation/Contract #: 050516PW 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 (Company Name) this day of,20. Notary Public [seal of notary] My commission expires: