ONE (1), LPG POWERED SOLID TIRE FORKLIFT For the Boone County Public Works Solid Waste Department

Similar documents
ONE (1), 2016 OR NEWER DIESEL POWERED, SINGLE AXLE TRUCK (37,600# GVW) WITH TEN FOOT DUMP BED For the Boone County Public Works Departments

City of Glasgow Department of Public Works Purchase of (1) 2013 White Rear Load Garbage Truck

CITY OF PORTSMOUTH PURCHASING DEPARTMENT PORTSMOUTH, NEW HAMPSHIRE. Annual Fuel Bid - #01-18 INVITATION TO BID

A summary of the vehicle to be purchased: Department Type of Vehicle Quantity Stormwater Department One Ton Dual Rear Wheel Dump Truck w/ Bed 1

INVITATION TO BID 61 ZERO TURN RADIUS MOWER

INVITATION TO BID. January 10, 2018

INVITATION TO BID (ITB)

NOTICE INVITING BIDS 2018 DEPARTMENT OF PUBLIC WORKS VEHICLE CITY OF BEAVER DAM, WISCONSIN

PROPOSAL FORM 2014 FUEL BID

The attached pre-qualification application should be submitted with your bid, in a separate sealed envelope.

SECTION 1 - APPLICANT INFORMATION. 1) Legal Name: 2) Mailing Address: 3) Physical Address (if different from mailing address):

INVITATION TO BID (ITB)

INVITATION TO BID PURCHASING DEPARTMENT P. O. BOX E. CENTRAL AVENUE THIRD FLOOR VALDOSTA, GEORGIA 31601

SINGLE AXLE DUMP TRUCK

INVITATION TO BID Fort Morgan Golf Course Golf Carts

Request for Proposal. Articulated Loader

INVITATION TO BID FUEL PRODUCTS

OFFICE OF SUPERINTENDENT DELAWARE COMMUNITY SCHOOL CORPORATION 9750 N CR 200 East Muncie, IN Phone: Fax:

9,000 lb. Forklift w/tire Changing Attachment (Propane) Req. 18-GA Georgia Ports Authority. Section 3 - Performance Specs Page 1 of 7

CUBA-RUSHFORD CENTRAL SCHOOL DISTRICT 5476 ROUTE 305 CUBA, NEW YORK ******** BID FORM FOR. Truck 2018 or Newer ********

INVITATION TO BID PURCHASING DEPARTMENT P. O. BOX E. CENTRAL AVENUE THIRD FLOOR VALDOSTA, GEORGIA 31601

Invitation to Bid NEW FOUR WHEEL DRIVE EXTENDED CAB PICKUP TRUCK

CITY OF UNION CITY. County of Hudson State of New Jersey CORPORATION APPLICATION FOR LICENSE FOR BUSINESS OR OCCUPATION TOWING

INVITATION TO BID PURCHASING DEPARTMENT P.O. BOX NORTH ASHLEY ST. VALDOSTA, GEORGIA #LC

CLEVELAND COUNTY NORTH CAROLINA REQUEST FOR BID NEW 2012 EXCAVATOR

RFQ Fleet Vehicles. The City of Dawson Creek is requesting quotations for the supply and delivery of:

CITY OF DIXON, CALIFORNIA CITY ENGINEER / PUBLIC WORKS DEPARTMENT, WASTEWATER DIVISION SOLANO COUNTY, CALIFORNIA BID SPECIFICATIONS

City of Hammond Purchasing Department RFP # General Maintenance and Repair Service Contract City Generators

CITY OF DUBUQUE VEHICLE BID BID DATE: 08/26/2016 BID DUE DATE: 09/12/2016 PURCHASING COORDINATOR'S OFFICE FINANCE DEPARTMENT 50 WEST 13TH STREET

ONE (1) CURRENT MODEL YEAR REGENERATIVE AIR TYPE STREET SWEEPER MOUNTED ON CONVENTIONAL CAB BID NO

INVITATION TO BID ONE (1) 10-FOOT DUMPBODY DUMP TRUCK WITH DIESEL / CNG OPTIONS

REGULATIONS OF THE DEPARTMENT OF PROCUREMENT SERVICES FOR CLEAN DIESEL CONTRACTING

Otsego County Road Commission

COUNTY OF ROCKLAND Department of General Services Purchasing Division

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT AFFIDAVIT AFFIDAVITS

One (1) New Ford F-150 Regular Cab XL Bid No Notice to Bidders

BOCC MEETING TRANSMITTAL. #4 - Effective and Responsive Government. Consent. Ongoing

(APPLICATIONS WILL NOT BE ACCEPTED WITHOUT ALL PAPERWORK):

H 8270 SUBSTITUTE A ======== LC006082/SUB A ======== S T A T E O F R H O D E I S L A N D

PRESSURE WASHER SYSTEM AND TRAILER, COMMERCIAL DUTY

SPECIFICATIONS AND BID FORM FOR ONE NEW SIX WHEEL DRIVE ARTICULATED MOTOR GRADER WITH SNOW GATE. Street Department

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE and House Bill 87, also known as, The Illegal Immigration Reform and Enforcement Act of 2011

CITY OF SHARON 155 W. CONNELLY BLVD SHARON, PENNSYLVANIA SPECIFICATIONS and FORM OF PROPOSAL

BULLOCH COUNTY BOARD OF COMMISSIONERS 115 NORTH MAIN STREET P. O. BOX 347 STATESBORO, GEORGIA INVITATION TO BID

Bartlesville Police Department CITY OF BARTLESVILLE, OKLAHOMA BID SPECIFICATIONS FOR Police Pursuit SUV Bid#

INVITATION TO BID PURCHASING DEPARTMENT P. O. BOX E. CENTRAL AVENUE SECOND FLOOR VALDOSTA, GEORGIA 31601

KENDALL COUNTY HIGHWAY DEPARTMENT

CITY OF HAYS, KANSAS BID PROPOSAL REQUEST FOR A COLD PLANER TABLE OF CONTENTS

Worcester Public Schools Student Transportation Contract Proposed Bid Specification Change Summary Sheet

INVITATION TO BID SPECIFICATIONS & INSTRUCTIONS FOR:

PURCHASING DEPARTMENT

Dubuque Community School District SPECIFICATIONS BID FORM AND TIME AND PLACE OF FILING

Department of Finance Purchasing Department INVITATION TO BID

REQUEST FOR BID For Trucks. Bid Notice

City of Winter Springs GOLF CART REGISTRATION PACKET. Applicant s Name: Address: City, State Zip. Driver s License No. Additional Drivers

REQUEST FOR PROPOSALS FIRE HYDRANT MAINTENANCE SERVICES

BID FOR A ONE (1) ONE-TON AND A HALF (5500 SERIES) CREWCAB TRUCK WITH DUMP BED. BID OPENING February 15, 2017 AT 10:00 A.M.

ALLEGANY COUNTY COMMISSIONERS ALLEGANY COUNTY DEPARTMENT OF PUBLIC WORKS. June 2018 BIDDING SPECIFICATIONS FOR NEW ONE-HALF TON PICKUP TRUCKS

REQUEST FOR BID For Trucks. Bid Notice

DEPARTMENT OF PUBLIC WORKS WHITMAN COUNTY COLFAX, WASHINGTON Bid for One (1) New Diesel Powered Articulated Four Wheel Drive Loader & Trade

FLORIDA SHERIFFS ASSOCIATION, FLORIDA FIRE CHIEFS ASSOCIATION, & FLORIDA ASSOCIATION OF COUNTIES

Three (3) New Ford Fusion Sedans Bid No Notice to Bidders

CITY OF NIAGARA FALLS, NEW YORK

Purchasing Services 4202 East Fowler Avenue, SVC 1073 Tampa, Florida (813) Addendum No. 1

Applicant Information All spaces must be filled in. Applications with blank spaces will be rejected.

BID FOR ONE (1) 1 TON CREW CAB TRUCK WITH SERVICE BODY OPENING APRIL 11, 2019 AT 10:00 A.M.

REQUEST FOR BIDS (RFB) # (1) NEW X4-3/4 TON EXTENDED CAB PICKUP TRUCK WITH LIFT GATE POSTING DATE: MARCH 7, 2018

CITY OF DOUGLAS BID PACKAGE NEW SPECIFIED 2019 HALF-TON 4X4 PICKUP TRUCK

CONTRACT DOCUMENTS TOWING SERVICES BOROUGH OF CARLISLE 53 W. SOUTH STREET CARLISLE, PENNSYLVANIA (717)

THREE (3) NEW 2018 SIX WHEEL DRIVE MOTOR GRADER WITH LIFT GROUP, REAR-RIPPER/SCARIFIER, AND SNOW WING.

INVITATION TO BID. Should you need clarification on any item, please contact Berley Mears, Public Works Director at

` Coweta County, Georgia Commercial / Special Use Application (Please allow up to two weeks to process applications)

CHARTER TOWNSHIP OF MUSKEGON COUNTY OF MUSKEGON STATE OF MICHIGAN

SOUTH DAKOTA. Definitions

INVITATION TO BID PURCHASING DEPARTMENT P. O. BOX E. CENTRAL AVENUE THIRD FLOOR VALDOSTA, GEORGIA 31601

2018 Golf Cart Lease Sunset Valley Golf Club

Request for Bids INFORMATION FOR BIDDERS. FURNISH THE CITY OF DERBY, KANSAS, ONE (1)2014 or NEWER TANDEM AXLE 10 YARD DUMP TRUCK w/ PLOW

NOTICE OF INVITATION FOR COMPETITIVE SEALED BIDS FOR MOTOR GRADERS (Guadalupe County IFB No )

Request for Proposal Snow Blower October 12, 2015

General Specifications

Request For Bids Elko County Solid Waste Refuse Hauling and Disposal in the Midas Solid Waste Management Districts

SOMERSET BOROUGH TECHNICAL SPECIFICATIONS FOR A USED 1-TON STYLE DUMP BODY TRUCK

HOUSE BILL NO. HB0235. Sponsored by: Representative(s) Roscoe and Miller A BILL. for. AN ACT relating to motor vehicles; providing that the

City of Lewiston Finance Department Allen Ward, Purchasing Agent

Phenix City Schools BID NO. GF Purchase of Three New Vehicles. Bid Opening Date & Time: January 7, 2019 at 9:00 AM EST

Invitation to Bid BOE. Ground Maintenance Equipment

CITY AND COUNTY OF SAN FRANCISCO. SPECIFICATION FOR Copier Lease Agreement Last revision 03/03/2016

ADDENDUM NO. 1. April 6, Project: Gas and Diesel Bid for School System Stations

City Business Registration Number Signature Title

INVITATION to BID. SALE OF SURPLUS VEHICLES Project # MARTHA S VINEYARD TRANSIT AUTHORITY 11 A STREET BUSINESS PARK EDGARTOWN, MA 02539

ITEM 1 - FORKLIFT, 6000-LBS, LP, DUAL FRONT DRIVE WHEELS (1 each)

HORRY COUNTY SOLID WASTE AUTHORITY, INC.

Dinwiddie County Administration Office

COUNTY OF BERKS Purchasing Department Berks County Services Center, 633 Court Street, Reading, PA Tel: Fax:

REQUEST FOR QUOTES Invitation to Bid

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

145 HP, FRONT WHEEL ASSIST TRACTOR 3/17/15 Page 1. Mountrail County Road and Bridge SPECIFICATIONS FOR

Town of South Windsor, Connecticut. Police Department

TOWING & IMMOBILIZATION CERTIFICATE APPLICATION. Indicate the type of service and the number of vehicle permits to perform this service.

City of Portsmouth Portsmouth, New Hampshire Department of Public Works. Bid# Five (5) 2018 Ford Trucks INVITATION TO BID

Transcription:

Boone County, Kentucky INVITATION FOR BID #022516PW ONE (1), LPG POWERED SOLID TIRE FORKLIFT For the Boone County Public Works Solid Waste Department ACCEPTANCE DATE: Prior to 2:00 p.m., February 25, 2016 Local time ACCEPTANCE PLACE Boone County Fiscal Court 2950 Washington Street Office of the Purchasing Agent 2 nd Floor Administration Building Burlington, Kentucky 41005 Requests for information related to this Invitation should be directed to: Billy Angel Fleet Supervisor (859) 334-3592 E-mail address: bangel@boonecountyky.org Issue Date: February 18, 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

The Boone County Fiscal Court will receive sealed bids in the Office of the Purchasing Agent, Second Floor, Administration Building, 2950 Washington Street, PO Box 900, Burlington, Kentucky 41005, until 2:00 p.m., February 25, 2016 for one LPG Powered Solid Tire Forklift for the Boone County Solid Waste Department. Bids will be opened and publicly read aloud at that time in the Fiscal Courtroom, First Floor, Administration Building. Late, electronically submitted or facsimile bids will not be accepted. BID ENVELOPE MUST BE LABELED: "SEALED BID: Forklift. Envelopes must also be labeled with the name and address of the vendor submitting the bid Specifications may be obtained in the Office of the Purchasing Agent, 2950 Washington St, Second Floor, Administration Building, 2950 Washington Street, Burlington, KY 41005. Boone County reserves the right to reject any and all bids, to waive any informalities and to negotiate for the modifications of any bid or to accept that 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 may be withdrawn for a period of thirty (30) days after scheduled time of receipt of bids. INTENT Whenever a specific Brand Name is used in these specifications, it is used for descriptive purposes only. Whenever or where the Bidder takes exceptions to the Specifications, such exceptions shall be listed on the Exception Sheet, of these specifications, and signed by the Bidder. The Bidder must use the attached Bid Form as no other form will be accepted. The Bidder shall also attach to the Bid Form, descriptive information and literature showing the items on which the Bid was based. The Boone County Public Works Fleet Supervisor shall be the sole judge of whether a Bid meets the intent of these specifications. 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.

GENERAL CONDITIONS The Forklift shall be a regular production model for which published specifications are available. The forklift that is bid must have a minimum of five (5) years of documented usage in the area for which the forklift is intended to be used. The Forklift shall have a minimum operating capacity of 5000 pounds (+/-) and shall meet all OSHA and EPA requirements in effect on the date of Bid Opening. PROPOSED BID YEAR 2015 or newer MAKE MODEL OPERATING CAPACITY LBS. ENGINE The engine shall be a 2.0 L 4 cylinder LPG HORSEPOWER with a minimum of 50 horsepower (+/-). The The engine shall have a minimum of TORQUE 110 lb/ft of torque (+/-). The engine shall be equipped with the standard air, fuel, and oil filters and the crankcase shall hold a minimum of 5 U.S. quarts OIL CAPACITY qts. of oil and fitted with a heavy duty oil cooler. OIL COOLER YES NO The engine cooling system shall be heavy duty and filled with permanent type anti-freeze and hold a minimum COOLANT gal. of 2 U.S. gallons of coolant. The LPG fuel tank shall hold a minimum of 5.0 U.S. gallons of LPG fuel. The LPG engine shall have a cold weather starting package installed as part of this bid. TRANSMISSION AND AXLES The transmission shall be a single speed powershift design, with 1 speed forward and 1 speed reverse. The Transmission Control shall be column mounted and be operator friendly from the left hand side. TRANS TYPE The steering shall be POWER STEERING BRAKES The brakes shall be manual adjusting hydraulic. The parking brake shall be mechanical/ratchet type. BRAKE TYPE

HYDRAULIC SYSTEM The hydraulic system must be an open center, fixed displacement, internal gear type with a main pump pressure of 2500 (+/-) PSI minimum. The pump must be flow rated at 5.0 gpm minimum. The hydraulic system must have a priorty valve for the hydraulic steering. The hydraulic tank must have a 150 micron in-tank oil filter and a 15 micron in-tank return oil filter. The hydraulic valve must be a 3 Section valve with a fourth lever. PUMP TYPE PUMP PRESSURE PUMP FLOW GPM TIRES The front and rear tires shall be single solid design and suitable for forklift service. The front tire size shall be 7.00 x 12-12PR. The rear tire size shall be 6.00 x 9-10PR. FRONT TIRES REAR TIRES ELECTRICAL SYSTEM The electrical system shall be a 12 volt negative VOLTS ground system. The system shall include 1 (one) BATTERIES 12 volt maintenance free battery with a minimum ALTERNATOR AMPS of 800 CCA. The alternator shall be a heavy duty type with a minimum 45 amp rating. The starting system shall be direct 12 volt with the ignition start/stop key mounted in the instrument panel. The lighting system shall consist of two front, two WORK LIGHTS combination stop, turn and taillights. The STOP, TURN, TAIL turn signal switch shall be mounted on the steering TURN SIGNALS column and a hazard lamp switch shall also be HAZARD SWITCH provided. An electric operated horn shall be made BACK-UP ALARM standard with these specifications. An electronic back-up alarm warning device is to be made part of these specifications.

ROPS AND OPERATOR CONTROLS The forklift is to have an OSHA approved ROPS SYSTEM as part of its standard equipment. The instrumentation shall include, a battery voltage, engine oil pressure and coolant temperature gauge, fuel level gauge, air filter restriction gauge, and an engine hour meter. ROPS SYSTEM INSTRUMENTATION LIFT SYSTEM The lift mast shall be a high visibility triplex, Industrial Truck Association class II mast. The maximum fork height shall be 188.0 (+/-), the overall lower height shall be 84.5 (+/-), and the full free height shall be 36.0 (+/-). The carriage shall be an Industrial Truck Association class II, Hook Type. The forklift shall be equipped with a hydraulically operated side shift and a dealer installed long reach rotator attachment option. For the front forks (any additional installation costs for the Side shifter/long reach rotator attachment Option shall be made part of the bid). The front lift forks shall be Industrial Truck Association class II, hook type, with a minimum Pallet (pair) length of 60 and a width of 4. The load backrest Shall be 48 high standard with mast. The front mast tilt cylinders Shall move 6 degrees forward and 6 degrees back. WARRANTY and MISCELLANIOUS The warranty shall cover the total machine for 1 year or 2000 hours with an extended Power Train warranty of 4 years or 5000 hours whichever occurs first, from the date of delivery. The successful bidder shall provide one complete each, operator manual, parts manual and shop repair manual. The Bidder shall include a minimum of 4 hours of training time for the Boone County Public Works shop personnel, to be held at the Public Works Maintenance Garage, in servicing and maintaining the unit supplied. WARRANTY PERIOD MANUALS PROVIDED SHOP TRAINING ALTERNATE EQUIPMENT OPTIONS: Factory installed hang on side shifter Dealer installed long reach rotator attachment

DELIVERY SPECIFIC CONDITIONS The successful Bidder must make delivery of the machine that is bid along with final invoicing, within 60-75days of receipt of purchase order. If this condition is not or cannot be met, the Boone County Fiscal Court will reject any and all Bids. DELIVERY DATE The successful Bidder states that they maintain a Factory Service Facility within 75 miles of Burlington, Kentucky and is staffed with Factory Certified and Qualified service and parts personnel. They must also state that they store a representative supply of parts for the machine being bid and with provisions for securing parts within a reasonable length of time. SERVICE AREA MILES

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 identified 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 #:022516PW 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 #: 022516PW 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:

EXCEPTION TO SPECIFICATIONS Signature required, if exceptions are noted

BID FORM NOTE TO BIDDER: THIS BID FORM MUST BE USED, IF NOT THE BID MAY BE REJECTED. FURNISH AND SUPPLY ONE (1) NEW LPG POWERED, SOLID TIRE FORKLIFT, TO THE BOONE COUNTY PUBLIC WORKS DEPARTMENT FOR THE LUMP SUM OF $ ALTERNATE EQUIPMENT OPTIONS: Factory installed hang on side shifter $ Dealer installed long reach rotator attachment $ NAME OF BIDDER: DATE: ADDRESS: FEDERAL ID #: (W-9 attached) SIGNATURE: OFFICIAL TITLE: PHONE ( ) FAX ( ) Bid Accepted By: The Boone County Public Works Department, BY: TITLE: DATE:

BIDDER LIST EQUIPMENT DEPOT ATTN: JEFF AUG 1342 JAMIKE AVE ERLANGER, KY 41048 CLARK MATERIAL ATTN: SALES MANAGER 749 WEST SHORT ST LEXINGTON, KY 40508 SOUTHEASTERN EQUIPMENT CO ATTN: JERRY RICE 1982 FLORENCE PIKE BURLINGTON, KY 41005 NORTHERN KY TRACTOR & EQUIP ATTN: EQUIPMENT SALES MANAGER 11 SCHOOL ROAD WALTON, KY 41094 EQUIPMENT MAINTENENCE & REPAIR ATTN: MIKE ST.CLAIR 5885 STATE ROUTE 128 CINCINNATI, OHIO 45002 KMH SYSTEMS & EQUIPMENT ATTN: EQUIPMENTSALES 11512 GONDOLA ST CINCINNATI, OH 45241 KENTON EQUIPMENT CO ATTN: SALES MANAGER 1995 WALTON-NICHOLSON WALTON, KY 41094 WHAYNE SUPPLY CO. ATTN: RON BOIAN 195 LISLE INDUSTRIAL AVE LEXINGTON KY 40511