Dear Prospective Kansas Supplier
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Dear Prospective Kansas Supplier: Thank you for your interest in conducting business with the Boyd Gaming Property in Kansas. Boyd Gaming, in conjunction with State of Kansas documentation standards, requires potential Kansas suppliers to complete and submit a Kansas Non-Gaming Vendor Affidavit and Release form to attest to the business’ status as a Kansas business, company, or corporation. Please be sure to thoroughly review the business categories on the Kansas Non-Gaming Vendor Affidavit and Release and only select those categories that apply to your company. To help avoid processing delays, please ensure that all applicable questions and required information are thoroughly completed. In addition, please note that there are additional non-gaming vendor permitting requirements for any non-gaming vendors that expect to provide $250,000 or more in goods or services to the Boyd Gaming property in Kansas within a one-year period. Upon completion of the information, please send the original notarized Kansas Non-Gaming Vendor Affidavit and Release, along with your Vendor Certification, Minority Owned Business Affidavit, Woman Owned Business Affidavit, and Kansas Owned Business Affidavit (as applicable), via Express Mail or Federal Express to the appropriate address noted below. Faxed forms will not be accepted and will delay the supplier application process. Kansas Star Casino, LLC Attn: Executive Offices 777 Kansas Star Drive Mulvane, KS Completing the Kansas Non-Gaming Vendor Affidavit and Release does not guarantee any contracts or that we will do business with you. This is a necessary requirement which may allow you to competitively bid on goods and services in the future. Once again, we thank you for your interest in doing business with the Boyd Gaming’s Kansas property. If you have questions or require any additional information concerning the application process, please submit by clicking “Contact” on the supplier application website. Updated September, 2016 KANSAS NON-GAMING VENDOR DEFINITIONS Boyd Gaming, to the extent allowed by law, provides for the maximum practical opportunities to Kansas-owned, Kansas minority-owned, and Kansas woman-owned enterprises in the awarding of contracts for goods and services used by our Kansas property. The following definitions are provided to assist in completing the Kansas Non-Gaming Vendor Affidavit and Release, which serves as attestation to the ownership status of your company. Please note that any supplier application information which is incorrect, incomplete or is submitted without a signed, dated and notarized copy of the Kansas Non-Gaming Vendor Affidavit and Release will not be processed and will be immediately returned to the applicant. DEFINITIONS Business – any sole proprietorship, corporation, partnership or limited liability company. Control – means exercising the power to make commitments on behalf of the Business and to make all necessary policy decisions. Operate – means being actively involved in the day-to-day management of the Business. Commercial Domicile – means the place from which the business is directed or managed. Kansas Business– a business, company, corporation or firm which is at least 51 percent owned by one or more Kansas individuals and/or a corporation, limited liability company or other business entity with a legal and Commercial Domicile in Kansas who also Control and Operate the business shall be considered as having a Kansas Business for purposes of Kansas Gaming Control Law and Regulations. A business, company, corporation or firm qualified with the Secretary of State and authorized to do business in Kansas which has a physical presence in the state in the form of property or facilities owned or leased in Kansas and which employs Kansas residents and who Control or Operate the Kansas business activity or enterprise may be considered a Kansas Business. Kansas Minority Business Enterprise or Kansas Minority Owned Business – a Kansas Business that is at least 51 percent owned by one or more minority individuals who are citizens of the United States (or lawfully admitted permanent residents) who are African-American, Hispanic, Asian or Pacific Islander, American Indian or Alaskan Native and must also Control and Operate the Kansas Business. Kansas Women's Business Enterprise or Kansas Woman Owned Business – a Kansas Business that is at least 51 percent owned by one or more women who are citizens of the United States (or lawfully admitted permanent residents) and who also Control and Operate the Kansas Business. In determining whether a business is 51 percent owned by one or more women, the percentage ownership by a woman shall not be diminished by way of community property rules. Updated September, 2016 KANSAS NON-GAMING VENDOR AFFIDAVIT AND RELEASE (To be completed by non-gaming vendors doing business in Kansas only) The undersigned swears that he/she is the duly authorized representative of (Company Name) making this application and the foregoing statements, including statements and data provided in any attachment(s) to the application, are true and correct and include all material information necessary to identify and explain the operation of the business as well as to attest to its ownership pursuant to the following Sections. In completing Sections I – III, please refer to the above definitions and only check those that apply to your business. Section I - Are you a Kansas Business per the above definitions? Yes No Section II – Please check all boxes that are applicable and refer to the above definitions in this Affidavit. Kansas Minority Business Enterprise or Kansas Minority Owned Business Kansas Women's Business Enterprise or Kansas Woman Owned Business I am not a Kansas Minority or Women Owned Business Enterprise per the above definitions. I am a Minority or Women Owned Business Enterprise but am not considered a Kansas Business Section III – If you are a minority or women owned business, please complete the following: Do you have proof of status as a Minority or Women Owned Business Enterprise by a third party certification agency? Yes No If you answer Yes, please also submit a copy of your current certificate from the third party certification agency. You can upload this directly in your supplier registration form located on www.boydgaming.com If the undersigned is requesting Boyd Gaming to rely on the certification of another organization, the undersigned hereby affirmatively represents that the ownership and control of the business entity has not changed in any manner that would cause de-certification by said organization. Further, the undersigned understands that any false statements, omissions or material misrepresentations will be grounds for denial of certification, de-certification and/or for terminating any contract(s) which may be awarded and for initiating action under Federal and State Law concerning false statements. The undersigned further agrees to provide Boyd Gaming with any additional information that it deems necessary to make accurate assessments of this business’ eligibility as a Kansas-owned, Kansas minority-owned, or Kansas woman-owned Business. If there should be any change in ownership or control of this business, or in any other information submitted, the undersigned agree(s) to notify Boyd Gaming immediately. Updated September, 2016 _____________________________________ ________________________ Signature Date ________________________________________ ________________________ Printed Name Title ______________________ Phone Number SWORN TO AND SUBSCRIBED before me, Notary, this ____ day of _______________, 20____. ___________________________________________________ Notary Public NOTARY SEAL ___________________________________________________ In and for the Parish / County of Updated September, 2016 Certain non-gaming suppliers shall also be required to obtain a non-gaming supplier permit from the Kansas Racing and Gaming Commission, prior to providing goods and/or services to the Boyd Gaming property in Kansas which will equal or exceed $250,000 within a one-year period. Non-gaming suppliers that expect to conduct uninterrupted business of $250,000 or more with the Boyd Gaming property in Kansas within a one-year period must contact the Kansas Racing & Gaming Commission in a timely manner to begin the non-gaming supplier permit application process. The Statute defining both Kansas Gaming and Non-Gaming Suppliers is below: Kansas Racing and Gaming Commission Article 102.—GAMING SUPPLIER AND NON-GAMING SUPPLIER CERTIFICATION 112-102-2. Gaming supplier and non-gaming supplier defined. (a) Each person that performs one or more of the following shall be considered a gaming supplier: (1) Manufactures, sells, leases, supplies, or distributes devices, machines, equipment, accessories, or items that meet at least one of the following conditions: (A) are designed for use in a gaming facility; (B) are needed to carry out a lottery facility game; (C) have the capacity to affect the result of the play of a lottery facility game; or (D) have the capacity to affect the calculation, storage, collection, or control of the revenues from a gaming facility; (2) provides maintenance services or repairs gaming equipment, including slot machines; (3) provides services directly related to the management or administration of a gaming facility; (4) provides junket services; or (5) provides items or services that the commission has determined are used in or are incidental to gaming or to an activity of a gaming facility. (b)(1) Any