{
    "document_id": 16219,
    "filename": "Attachment_A_-24-03_Vendor_Affidavit.pdf",
    "engine": "paddleocr_vl",
    "source_run_id": 16330,
    "generated_at": "2026-11-04T18:06:01+00:00",
    "page_count": 2,
    "counts_by_type": {
        "form_field": 8,
        "heading": 5,
        "list": 4,
        "list_item": 18,
        "table": 2,
        "table_cell": 18,
        "text": 7,
        "title": 2
    },
    "timings": {
        "total_ms": 234,
        "structure_ms": 200,
        "text_layer_ms": 15,
        "build_ms": 9
    },
    "pages": [
        {
            "document_id": 16219,
            "page": 1,
            "width": 612,
            "height": 792,
            "rotation": 0,
            "pipeline_version": "paddleocr-vl-1.6+paul-48",
            "width_pt": 612,
            "height_pt": 792,
            "engine": "paddleocr_vl",
            "source_run_id": 16330,
            "item_count": 32,
            "counts_by_type": {
                "heading": 4,
                "list": 4,
                "list_item": 18,
                "table": 1,
                "table_cell": 2,
                "text": 2,
                "title": 1
            },
            "build_ms": 6,
            "items": [
                {
                    "id": "p1.1",
                    "order": 1,
                    "type": "title",
                    "bbox": {
                        "l": 183.6,
                        "t": 747.12,
                        "r": 401.04,
                        "b": 705.6
                    },
                    "text": "KENTUCKY STATE UNIVERSITY\nREQUEST FOR PROPOSAL (RFP)\nVENDOR AFFIDAVIT",
                    "attrs": {
                        "block_label": "doc_title"
                    },
                    "level": 2,
                    "reading_order": 0
                },
                {
                    "id": "p1.2",
                    "order": 2,
                    "type": "text",
                    "bbox": {
                        "l": 79.68,
                        "t": 694.8,
                        "r": 492.48,
                        "b": 682.08
                    },
                    "text": "ATTENTION: This is not an order. Read all instructions, terms and conditions carefully",
                    "reading_order": 1
                },
                {
                    "id": "p1.3",
                    "order": 3,
                    "type": "table",
                    "bbox": {
                        "l": 32.64,
                        "t": 674.16,
                        "r": 559.68,
                        "b": 583.68
                    },
                    "text": "",
                    "attrs": {
                        "block_label": "table",
                        "n_rows": 1,
                        "n_cols": 2,
                        "integrity": {
                            "cells_checked": 2,
                            "cells_flagged": 0
                        }
                    },
                    "children": [
                        {
                            "id": "p1.3.1",
                            "order": 4,
                            "type": "table_cell",
                            "bbox": {
                                "l": 39,
                                "t": 669.29128,
                                "r": 124.97472,
                                "b": 610.51828
                            },
                            "text": "PROPOSAL NO:\nIssue Date:\nPurchasing Official:\nPhone:\nType of Services",
                            "attrs": {
                                "row": 0,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true,
                                "merged_continuation": true
                            },
                            "reading_order": 0
                        },
                        {
                            "id": "p1.3.2",
                            "order": 5,
                            "type": "table_cell",
                            "bbox": {
                                "l": 145.46,
                                "t": 669.29128,
                                "r": 297.1508,
                                "b": 598.99828
                            },
                            "text": "RFP 24-03\nFebruary 13, 2024\nFran Pinkston\n(502) 597-6434\nCOURSE REDESIGN KSU 118\\nIntroduction to University Learning",
                            "attrs": {
                                "row": 0,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true,
                                "merged_continuation": true
                            },
                            "reading_order": 1
                        }
                    ],
                    "reading_order": 2
                },
                {
                    "id": "p1.4",
                    "order": 6,
                    "type": "heading",
                    "bbox": {
                        "l": 330,
                        "t": 672.24,
                        "r": 451.2,
                        "b": 659.52
                    },
                    "text": "SUBMIT PROPOSAL TO:",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 3
                },
                {
                    "id": "p1.5",
                    "order": 7,
                    "type": "list",
                    "bbox": {
                        "l": 332.35,
                        "t": 645.29128,
                        "r": 540.103,
                        "b": 586.51828
                    },
                    "text": "",
                    "attrs": {
                        "item_count": 5
                    },
                    "children": [
                        {
                            "id": "p1.5.1",
                            "order": 8,
                            "type": "list_item",
                            "bbox": {
                                "l": 332.35,
                                "t": 645.29128,
                                "r": 484.35952,
                                "b": 636.07828
                            },
                            "text": "KENTUCKY STATE UNIVERSITY",
                            "reading_order": 0
                        },
                        {
                            "id": "p1.5.2",
                            "order": 9,
                            "type": "list_item",
                            "bbox": {
                                "l": 332.35,
                                "t": 632.93128,
                                "r": 470.4952,
                                "b": 623.71828
                            },
                            "text": "PURCHASING DEPARTMENT",
                            "reading_order": 1
                        },
                        {
                            "id": "p1.5.3",
                            "order": 10,
                            "type": "list_item",
                            "bbox": {
                                "l": 332.35,
                                "t": 620.45128,
                                "r": 540.103,
                                "b": 611.23828
                            },
                            "text": "ACADEMIC SERVICES BUILDING SUITE 429",
                            "reading_order": 2
                        },
                        {
                            "id": "p1.5.4",
                            "order": 11,
                            "type": "list_item",
                            "bbox": {
                                "l": 332.35,
                                "t": 608.09128,
                                "r": 447.6868,
                                "b": 598.87828
                            },
                            "text": "400 EAST MAIN STREET",
                            "reading_order": 3
                        },
                        {
                            "id": "p1.5.5",
                            "order": 12,
                            "type": "list_item",
                            "bbox": {
                                "l": 332.35,
                                "t": 595.73128,
                                "r": 445.55536,
                                "b": 586.51828
                            },
                            "text": "FRANKFORT, KY 40601",
                            "reading_order": 4
                        }
                    ],
                    "reading_order": 4
                },
                {
                    "id": "p1.6",
                    "order": 13,
                    "type": "heading",
                    "bbox": {
                        "l": 92.16,
                        "t": 572.16,
                        "r": 481.2,
                        "b": 559.68
                    },
                    "text": "IMPORTANT: PROPOSALS MUST BE RECEIVED BY March 7, 2024 at 3:00 PM, ET",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 5
                },
                {
                    "id": "p1.7",
                    "order": 14,
                    "type": "list",
                    "bbox": {
                        "l": 35.52,
                        "t": 546.96,
                        "r": 557.52,
                        "b": 359.76
                    },
                    "text": "",
                    "attrs": {
                        "item_count": 6
                    },
                    "children": [
                        {
                            "id": "p1.7.1",
                            "order": 15,
                            "type": "list_item",
                            "bbox": {
                                "l": 35.52,
                                "t": 546.96,
                                "r": 557.04,
                                "b": 521.52
                            },
                            "text": "It is the intention of the Request for Proposal (RFP) to enter into competitive negotiation as authorized by KRS 45A.085.",
                            "marker": "1.",
                            "reading_order": 0
                        },
                        {
                            "id": "p1.7.2",
                            "order": 16,
                            "type": "list_item",
                            "bbox": {
                                "l": 36.48,
                                "t": 520.32,
                                "r": 557.52,
                                "b": 471.12
                            },
                            "text": "Proposals for competitive negotiation shall not be subject to public inspection until negotiations between Kentucky State University and all Vendors have been concluded and a contract awarded to the responsible Vendor submitting the proposal determined in writing to be the most advantageous to the University. Price and the evaluation factors set forth in the advertisement and solicitations for proposals will be considered.",
                            "marker": "2.",
                            "reading_order": 1
                        },
                        {
                            "id": "p1.7.3",
                            "order": 17,
                            "type": "list_item",
                            "bbox": {
                                "l": 36.48,
                                "t": 470.16,
                                "r": 556.8,
                                "b": 446.64
                            },
                            "text": "An award of contract may be made upon the basis of the initial written proposals received without written or oral discussions.",
                            "marker": "3.",
                            "reading_order": 2
                        },
                        {
                            "id": "p1.7.4",
                            "order": 18,
                            "type": "list_item",
                            "bbox": {
                                "l": 35.76,
                                "t": 445.68,
                                "r": 557.04,
                                "b": 421.68
                            },
                            "text": "Contracts resulting from the RFP shall be governed by and in accordance with the laws of the Commonwealth of Kentucky.",
                            "marker": "4.",
                            "reading_order": 3
                        },
                        {
                            "id": "p1.7.5",
                            "order": 19,
                            "type": "list_item",
                            "bbox": {
                                "l": 36,
                                "t": 420.72,
                                "r": 557.04,
                                "b": 397.68
                            },
                            "text": "The University reserves the right to request proposal amendments or modifications after the proposal receiving date.",
                            "marker": "5.",
                            "reading_order": 4
                        },
                        {
                            "id": "p1.7.6",
                            "order": 20,
                            "type": "list_item",
                            "bbox": {
                                "l": 36.24,
                                "t": 396.48,
                                "r": 557.52,
                                "b": 359.76
                            },
                            "text": "THE TERMS AND CONDITIONS OF THIS REQUEST FOR PROPOSAL INCLUDE ALL GENERAL CONDITIONS, AS SET FORTH BY KENTUCKY STATE UNIVERSITY PLUS ANY SPECIAL CONDIITIONS ENUMERATED HEREIN.",
                            "marker": "6.",
                            "reading_order": 5
                        }
                    ],
                    "reading_order": 6
                },
                {
                    "id": "p1.8",
                    "order": 21,
                    "type": "heading",
                    "bbox": {
                        "l": 288.48,
                        "t": 360,
                        "r": 331.2,
                        "b": 346.32
                    },
                    "text": "NOTICE",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 7
                },
                {
                    "id": "p1.9",
                    "order": 22,
                    "type": "list",
                    "bbox": {
                        "l": 35.76,
                        "t": 339.12,
                        "r": 557.52,
                        "b": 251.52
                    },
                    "text": "",
                    "attrs": {
                        "item_count": 2
                    },
                    "children": [
                        {
                            "id": "p1.9.1",
                            "order": 23,
                            "type": "list_item",
                            "bbox": {
                                "l": 36.48,
                                "t": 339.12,
                                "r": 556.08,
                                "b": 313.68
                            },
                            "text": "Any agreement of collusion among Firms or prospective Firms, which restrain or is reasonably calculated to restrain competition by agreement to proposal at a fixed price or to refrain from offering, or otherwise is prohibited.",
                            "marker": "1.",
                            "reading_order": 0
                        },
                        {
                            "id": "p1.9.2",
                            "order": 24,
                            "type": "list_item",
                            "bbox": {
                                "l": 35.76,
                                "t": 314.4,
                                "r": 557.52,
                                "b": 251.52
                            },
                            "text": "Any person who violates any provisions of KRS 45A.325 shall be guilty of a class D felony and shall be punished by a fine of not less than five thousand dollars, or be imprisoned not less than one year nor more than five years, or both such fine and imprisonment. Any Firm, corporation or association who violates any of the provisions of KRS 45A.325 shall, upon conviction, be fined not less than ten thousand dollars or more than twenty thousand dollars.",
                            "marker": "2.",
                            "reading_order": 1
                        }
                    ],
                    "reading_order": 8
                },
                {
                    "id": "p1.10",
                    "order": 25,
                    "type": "heading",
                    "bbox": {
                        "l": 45.84,
                        "t": 239.76,
                        "r": 547.92,
                        "b": 225.84
                    },
                    "text": "AUTHENTICATION OF RFP & STATEMENT OF NON-COLLUSION/NON-CONFLICT OF INTEREST",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 9
                },
                {
                    "id": "p1.11",
                    "order": 26,
                    "type": "text",
                    "bbox": {
                        "l": 54.72,
                        "t": 217.44,
                        "r": 504.72,
                        "b": 204.48
                    },
                    "text": "I hereby swear (or affirm) under the penalty for false swearing as provided by KRS 523.040:",
                    "reading_order": 10
                },
                {
                    "id": "p1.12",
                    "order": 27,
                    "type": "list",
                    "bbox": {
                        "l": 36,
                        "t": 203.28,
                        "r": 558,
                        "b": 39.84
                    },
                    "text": "",
                    "attrs": {
                        "item_count": 5
                    },
                    "children": [
                        {
                            "id": "p1.12.1",
                            "order": 28,
                            "type": "list_item",
                            "bbox": {
                                "l": 36.96,
                                "t": 203.28,
                                "r": 556.08,
                                "b": 177.12
                            },
                            "text": "That I am the Firm (if the Firm is an individual), a partner (if the Firm is a partnership), or an Officer or Employee of the bidding corporation having authority to sign on its behalf (if the Firm is a corporation);",
                            "marker": "1.",
                            "reading_order": 0
                        },
                        {
                            "id": "p1.12.2",
                            "order": 29,
                            "type": "list_item",
                            "bbox": {
                                "l": 36,
                                "t": 175.92,
                                "r": 557.52,
                                "b": 136.08
                            },
                            "text": "That the attached proposal has arrived at the Firm in independently, and has been submitted without collusion with, and without any agreement, understanding or planned common course of action with any other Firm, of materials, supplies, equipment or services described in the RFP.",
                            "marker": "2.",
                            "reading_order": 1
                        },
                        {
                            "id": "p1.12.3",
                            "order": 30,
                            "type": "list_item",
                            "bbox": {
                                "l": 36,
                                "t": 135.12,
                                "r": 558,
                                "b": 95.28
                            },
                            "text": "That the contents of the proposal have not been communicated by the Firm or its employees or agents to any person not an employee or agent of the Firm or its surety on any bond furnished with the proposal and will not be communicated to any such person prior to the official closing of the RFP.",
                            "marker": "3.",
                            "reading_order": 2
                        },
                        {
                            "id": "p1.12.4",
                            "order": 31,
                            "type": "list_item",
                            "bbox": {
                                "l": 36.24,
                                "t": 94.32,
                                "r": 546.72,
                                "b": 54.96
                            },
                            "text": "That the Firm is legally entitled to enter into contracts with the Kentucky State University and it not in violation of any prohibited conflict of interest, including those prohibited by the provisions of KRS 45A.330 through KRS 45A.340 and KRS 164.390.",
                            "marker": "4.",
                            "reading_order": 3
                        },
                        {
                            "id": "p1.12.5",
                            "order": 32,
                            "type": "list_item",
                            "bbox": {
                                "l": 36.24,
                                "t": 53.52,
                                "r": 480.72,
                                "b": 39.84
                            },
                            "text": "That I have fully informed myself regarding the accuracy of the statement made above.",
                            "marker": "5.",
                            "reading_order": 4
                        }
                    ],
                    "reading_order": 11
                }
            ]
        },
        {
            "document_id": 16219,
            "page": 2,
            "width": 612,
            "height": 792,
            "rotation": 0,
            "pipeline_version": "paddleocr-vl-1.6+paul-48",
            "width_pt": 612,
            "height_pt": 792,
            "engine": "paddleocr_vl",
            "source_run_id": 16330,
            "item_count": 32,
            "counts_by_type": {
                "form_field": 8,
                "heading": 1,
                "table": 1,
                "table_cell": 16,
                "text": 5,
                "title": 1
            },
            "build_ms": 3,
            "items": [
                {
                    "id": "p2.1",
                    "order": 1,
                    "type": "title",
                    "bbox": {
                        "l": 118.08,
                        "t": 735.12,
                        "r": 476.4,
                        "b": 722.64
                    },
                    "text": "SWORN STATEMENT OF COMPLIANCE WITH CAMPAIGN FINANCE LAWS",
                    "attrs": {
                        "block_label": "doc_title"
                    },
                    "level": 2,
                    "reading_order": 0
                },
                {
                    "id": "p2.2",
                    "order": 2,
                    "type": "text",
                    "bbox": {
                        "l": 56.16,
                        "t": 714.72,
                        "r": 556.32,
                        "b": 664.08
                    },
                    "text": "In accordance with KRS 45A.110(2), the undersigned hereby swears under penalty of perjury that he/she has not knowingly violated any provision of the campaign finance laws of the Commonwealth of Kentucky and that the award of a contract to a Firm will not violate any provision of the campaign finance laws of the Commonwealth of Kentucky.",
                    "reading_order": 1
                },
                {
                    "id": "p2.3",
                    "order": 3,
                    "type": "text",
                    "bbox": {
                        "l": 73.2,
                        "t": 657.36,
                        "r": 522,
                        "b": 644.16
                    },
                    "text": "FIRM REPORT OF PRIOR VIOLATIONS OF KRS CHAPTERS 136, 139, 141, 337, 338, 341 & 342",
                    "reading_order": 2
                },
                {
                    "id": "p2.4",
                    "order": 4,
                    "type": "text",
                    "bbox": {
                        "l": 55.92,
                        "t": 636.48,
                        "r": 556.32,
                        "b": 561.12
                    },
                    "text": "The Firm by signing and submitting a proposal agrees as required by KRS 45A.485 to submit final determinations of any violations of the provisions of KRS Chapters 136, 139, 141, 337, 338, 341 and 342 that have occurred in the previous five (5) years prior to the award of a contract and agreements to remaining continuous compliance with the provisions of the statutes during the duration of any contract that may be established. Final determinations of violations of these statutes must be provided to the University by the successful Firm prior to the award of a contract.",
                    "reading_order": 3
                },
                {
                    "id": "p2.5",
                    "order": 5,
                    "type": "heading",
                    "bbox": {
                        "l": 170.64,
                        "t": 554.88,
                        "r": 425.04,
                        "b": 541.68
                    },
                    "text": "CERTIFICATION OF NON-SEGREGATED FACILITIES",
                    "attrs": {
                        "block_label": "paragraph_title"
                    },
                    "level": 3,
                    "reading_order": 4
                },
                {
                    "id": "p2.6",
                    "order": 6,
                    "type": "text",
                    "bbox": {
                        "l": 56.64,
                        "t": 534,
                        "r": 550.8,
                        "b": 507.84
                    },
                    "text": "The Firm, by submitting a proposal, certifies that he/she is in compliance with the Code of Federal Regulations, 41 CFR 60-1.8 that prohibits the maintaining of segregated facilities.",
                    "reading_order": 5
                },
                {
                    "id": "p2.7",
                    "order": 7,
                    "type": "text",
                    "bbox": {
                        "l": 29.04,
                        "t": 476.64,
                        "r": 544.08,
                        "b": 423.12
                    },
                    "text": "SIGNATURE REQUIRED: This proposal cannot be considered valid unless signed and dated by an authorized agent of the Firm. Type or print the signatory's name, title, address, phone number and fax number in the spaces provided. Offers signed by an agent are to be accompanied by evidence of his/her authority unless such evidence has been previously furnished to the issuing office.",
                    "reading_order": 6
                },
                {
                    "id": "p2.8",
                    "order": 8,
                    "type": "table",
                    "bbox": {
                        "l": 28.32,
                        "t": 384.48,
                        "r": 543.6,
                        "b": 234.96
                    },
                    "text": "",
                    "attrs": {
                        "block_label": "table",
                        "n_rows": 4,
                        "n_cols": 4,
                        "integrity": {
                            "cells_checked": 10,
                            "cells_flagged": 0
                        }
                    },
                    "children": [
                        {
                            "id": "p2.8.1",
                            "order": 9,
                            "type": "table_cell",
                            "bbox": {
                                "l": 32.28,
                                "t": 373.27672,
                                "r": 115.55472,
                                "b": 363.06472
                            },
                            "text": "Company Name",
                            "attrs": {
                                "row": 0,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true,
                                "column_header": true,
                                "header_source": "heuristic"
                            },
                            "children": [
                                {
                                    "id": "p2.8.1.1",
                                    "order": 10,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 32.28,
                                        "t": 397.978,
                                        "r": 264.8597,
                                        "b": 382.809
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "source": "blank_line",
                                        "row": 0,
                                        "col": 0,
                                        "rowspan": 1,
                                        "colspan": 1,
                                        "label": "Company Name",
                                        "label_source": "parent_text",
                                        "label_ref": "p2.8.1"
                                    },
                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 0
                        },
                        {
                            "id": "p2.8.2",
                            "order": 11,
                            "type": "table_cell",
                            "bbox": {
                                "l": 157.14,
                                "t": 384.48,
                                "r": 285.96,
                                "b": 347.1
                            },
                            "text": "",
                            "attrs": {
                                "row": 0,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1
                            },
                            "children": [
                                {
                                    "id": "p2.8.2.1",
                                    "order": 12,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 32.28,
                                        "t": 356.318,
                                        "r": 270.9798,
                                        "b": 341.149
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "source": "blank_line",
                                        "row": 0,
                                        "col": 1,
                                        "rowspan": 1,
                                        "colspan": 1
                                    },
                                    "reading_order": 0
                                },
                                {
                                    "id": "p2.8.2.2",
                                    "order": 13,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 283.61,
                                        "t": 356.318,
                                        "r": 540.6694,
                                        "b": 341.149
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "source": "blank_line",
                                        "row": 0,
                                        "col": 1,
                                        "rowspan": 1,
                                        "colspan": 1
                                    },
                                    "reading_order": 1
                                }
                            ],
                            "reading_order": 1
                        },
                        {
                            "id": "p2.8.3",
                            "order": 14,
                            "type": "table_cell",
                            "bbox": {
                                "l": 283.61,
                                "t": 373.27672,
                                "r": 394.92632,
                                "b": 363.06472
                            },
                            "text": "Authorized Signature",
                            "attrs": {
                                "row": 0,
                                "col": 2,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true,
                                "column_header": true,
                                "header_source": "heuristic"
                            },
                            "children": [
                                {
                                    "id": "p2.8.3.1",
                                    "order": 15,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 283.61,
                                        "t": 397.978,
                                        "r": 540.6887,
                                        "b": 382.809
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "source": "blank_line",
                                        "row": 0,
                                        "col": 2,
                                        "rowspan": 1,
                                        "colspan": 1,
                                        "label": "Authorized Signature",
                                        "label_source": "parent_text",
                                        "label_ref": "p2.8.3"
                                    },
                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 2
                        },
                        {
                            "id": "p2.8.4",
                            "order": 16,
                            "type": "table_cell",
                            "bbox": {
                                "l": 507.87656,
                                "t": 373.27672,
                                "r": 531.64568,
                                "b": 363.06472
                            },
                            "text": "Date",
                            "attrs": {
                                "row": 0,
                                "col": 3,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true,
                                "column_header": true,
                                "header_source": "heuristic"
                            },
                            "reading_order": 3
                        },
                        {
                            "id": "p2.8.5",
                            "order": 17,
                            "type": "table_cell",
                            "bbox": {
                                "l": 32.76,
                                "t": 331.61672,
                                "r": 76.93104,
                                "b": 321.40472
                            },
                            "text": "Address",
                            "attrs": {
                                "row": 1,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true
                            },
                            "reading_order": 4
                        },
                        {
                            "id": "p2.8.6",
                            "order": 18,
                            "type": "table_cell",
                            "bbox": {
                                "l": 157.14,
                                "t": 347.1,
                                "r": 285.96,
                                "b": 309.72
                            },
                            "text": "",
                            "attrs": {
                                "row": 1,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1
                            },
                            "reading_order": 5
                        },
                        {
                            "id": "p2.8.7",
                            "order": 19,
                            "type": "table_cell",
                            "bbox": {
                                "l": 283.61,
                                "t": 331.61672,
                                "r": 404.1668,
                                "b": 321.40472
                            },
                            "text": "Typed or Printed Name",
                            "attrs": {
                                "row": 1,
                                "col": 2,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true
                            },
                            "reading_order": 6
                        },
                        {
                            "id": "p2.8.8",
                            "order": 20,
                            "type": "table_cell",
                            "bbox": {
                                "l": 414.78,
                                "t": 347.1,
                                "r": 543.6,
                                "b": 309.72
                            },
                            "text": "",
                            "attrs": {
                                "row": 1,
                                "col": 3,
                                "rowspan": 1,
                                "colspan": 1
                            },
                            "reading_order": 7
                        },
                        {
                            "id": "p2.8.9",
                            "order": 21,
                            "type": "table_cell",
                            "bbox": {
                                "l": 32.28,
                                "t": 289.97672,
                                "r": 108.77616,
                                "b": 279.76472
                            },
                            "text": "City, State, Zip",
                            "attrs": {
                                "row": 2,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true
                            },
                            "children": [
                                {
                                    "id": "p2.8.9.1",
                                    "order": 22,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 32.28,
                                        "t": 273.158,
                                        "r": 270.9798,
                                        "b": 257.9891
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "source": "blank_line",
                                        "row": 2,
                                        "col": 0,
                                        "rowspan": 1,
                                        "colspan": 1,
                                        "label": "City, State, Zip",
                                        "label_source": "parent_text",
                                        "label_ref": "p2.8.9"
                                    },
                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 8
                        },
                        {
                            "id": "p2.8.10",
                            "order": 23,
                            "type": "table_cell",
                            "bbox": {
                                "l": 157.14,
                                "t": 309.72,
                                "r": 285.96,
                                "b": 272.34
                            },
                            "text": "",
                            "attrs": {
                                "row": 2,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1
                            },
                            "children": [
                                {
                                    "id": "p2.8.10.1",
                                    "order": 24,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 32.28,
                                        "t": 314.678,
                                        "r": 270.9798,
                                        "b": 299.509
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "source": "blank_line",
                                        "row": 2,
                                        "col": 1,
                                        "rowspan": 1,
                                        "colspan": 1
                                    },
                                    "reading_order": 0
                                },
                                {
                                    "id": "p2.8.10.2",
                                    "order": 25,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 283.61,
                                        "t": 314.678,
                                        "r": 540.6694,
                                        "b": 299.509
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "source": "blank_line",
                                        "row": 2,
                                        "col": 1,
                                        "rowspan": 1,
                                        "colspan": 1
                                    },
                                    "reading_order": 1
                                }
                            ],
                            "reading_order": 9
                        },
                        {
                            "id": "p2.8.11",
                            "order": 26,
                            "type": "table_cell",
                            "bbox": {
                                "l": 283.61,
                                "t": 289.97672,
                                "r": 306.2972,
                                "b": 279.76472
                            },
                            "text": "Title",
                            "attrs": {
                                "row": 2,
                                "col": 2,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true
                            },
                            "reading_order": 10
                        },
                        {
                            "id": "p2.8.12",
                            "order": 27,
                            "type": "table_cell",
                            "bbox": {
                                "l": 414.78,
                                "t": 309.72,
                                "r": 543.6,
                                "b": 272.34
                            },
                            "text": "",
                            "attrs": {
                                "row": 2,
                                "col": 3,
                                "rowspan": 1,
                                "colspan": 1
                            },
                            "reading_order": 11
                        },
                        {
                            "id": "p2.8.13",
                            "order": 28,
                            "type": "table_cell",
                            "bbox": {
                                "l": 32.28,
                                "t": 248.33672,
                                "r": 110.59776,
                                "b": 238.12472000000002
                            },
                            "text": "Phone Number",
                            "attrs": {
                                "row": 3,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true
                            },
                            "reading_order": 12
                        },
                        {
                            "id": "p2.8.14",
                            "order": 29,
                            "type": "table_cell",
                            "bbox": {
                                "l": 175.58,
                                "t": 248.33672,
                                "r": 239.29184,
                                "b": 238.12472000000002
                            },
                            "text": "Fax Number",
                            "attrs": {
                                "row": 3,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true
                            },
                            "reading_order": 13
                        },
                        {
                            "id": "p2.8.15",
                            "order": 30,
                            "type": "table_cell",
                            "bbox": {
                                "l": 283.61,
                                "t": 248.33672,
                                "r": 438.9428,
                                "b": 238.12472000000002
                            },
                            "text": "Federal Identification Number",
                            "attrs": {
                                "row": 3,
                                "col": 2,
                                "rowspan": 1,
                                "colspan": 1,
                                "bbox_refit": true
                            },
                            "reading_order": 14
                        },
                        {
                            "id": "p2.8.16",
                            "order": 31,
                            "type": "table_cell",
                            "bbox": {
                                "l": 414.78,
                                "t": 272.34,
                                "r": 543.6,
                                "b": 234.96
                            },
                            "text": "",
                            "attrs": {
                                "row": 3,
                                "col": 3,
                                "rowspan": 1,
                                "colspan": 1
                            },
                            "children": [
                                {
                                    "id": "p2.8.16.1",
                                    "order": 32,
                                    "type": "form_field",
                                    "bbox": {
                                        "l": 283.61,
                                        "t": 273.158,
                                        "r": 540.6694,
                                        "b": 257.9891
                                    },
                                    "text": "",
                                    "attrs": {
                                        "field_kind": "text",
                                        "source": "blank_line",
                                        "row": 3,
                                        "col": 3,
                                        "rowspan": 1,
                                        "colspan": 1
                                    },
                                    "reading_order": 0
                                }
                            ],
                            "reading_order": 15
                        }
                    ],
                    "reading_order": 7
                }
            ]
        }
    ]
}