Attachment B - Affidavit for Resident Bidder Status

Solicitation #: ___

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
  3. Filed Kentucky corporate income taxes;
  4. Made payments to the Kentucky unemployment insurance fund established in KRS 341.49; and
  5. 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.

SignaturePrinted Name
TitleDate
Company Name
Address

Subscribed and sworn to before me by

(Affiant) (Title)

of _____ this _____day of _____,20___.

(Company Name)

___

Notary Public

[seal of notary]

Eastern Kentucky University

My commission expires: