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KENTUCKY STATE UNIVERSITY REQUEST FOR PROPOSAL (RFP) VENDOR AFFIDAVIT

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

SUBMIT PROPOSAL TO:

KENTUCKY STATE UNIVERSITY PURCHASING DEPARTMENT ACADEMIC SERVICES BUILDING SUITE 317 400 EAST MAIN STREET FRANKFORT, KY 40601

IMPORTANT: PROPOSALS MUST BE RECEIVED BY May 29, 2:00 PM, ET

1. It is the intention of the Request for Bid (RFB) to enter into competitive negotiation as authorized by KRS 45A.085.
2. 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.
3. An award of contract may be made upon the basis of the initial written proposals received without written or oral discussions.
4. Contracts resulting from the RFB shall be governed by and in accordance with the laws of the Commonwealth of Kentucky.
5. The University reserves the right to request proposal amendments or modifications after the proposal receiving date.
6. 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.

NOTICE

1. 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.
2. 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.

AUTHENTICATION OF RFP & STATEMENT OF NON-COLLUSION/NON-CONFLICT OF INTEREST

I hereby swear (or affirm) under the penalty for false swearing as provided by KRS 523.040:

1. 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);
2. 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.
3. 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.
4. 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.
5. That I have fully informed myself regarding the accuracy of the statement made above.

SWORN STATEMENT OF COMPLIANCE WITH CAMPAIGN FINANCE LAWS

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.

FIRM REPORT OF PRIOR VIOLATIONS OF KRS CHAPTERS 136, 139, 141, 337, 338, 341 & 342

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.

CERTIFICATION OF NON-SEGREGATED FACILITIES

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.

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.