_2023- Annual Required Affidavit for Bidders Offerors and Contractors.pdf
PDF 253 KB Posted
- Attached to
- KYPCIS Bowling Green Seminar Catering/FY26
- Solicitation number
- RFQ-525-2500000045-1
- Issued by
- Wayne County, Kentucky
About this file
This is a Required Affidavit form issued by the Commonwealth of Kentucky (revised 9-16-22) that must be completed by bidders, offerors, and contractors pursuant to KRS 45A.110 and 45A.115. The affidavit is required for either the initial award of a contract or contract renewal, and remains effective for one year from the date of execution. The document requires an authorized representative of the contracting party to complete an attestation, have it notarized, and return it to the Commonwealth.
The form requires the contractor to attest under penalty of perjury that they have not knowingly violated campaign finance laws of Kentucky and that the contract award will not violate any campaign finance laws. The document includes fields for the representative's signature, printed name, title, date, company information (including name and address), Commonwealth of Kentucky Vendor Code, and notary information. "Knowingly" is defined in the document as being aware or having should been aware of a violation's existence.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFQ_525_2500000045_1_SO_FORM.PDF | ||
| Food Matrix FY26 Bowling Green.xlsx | XLSX spreadsheet |
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Text version
Rev. 9-16-22
Required Affidavit for Bidders, Offerors and Contractors
(KRS 45A.110 & 45A.115)
Affidavit Effective for One (1) Year from Date of Execution
Instructions: Pursuant to KRS 45A.110 and 45A.115, a bidder, offeror, or contractor
(“Contractor”) is required to submit a Required Affidavit for Bidders, Offerors, and Contractors to be awarded a contract, or for the renewal of a contract. An authorized representative of the contracting party must complete the attestation below, have the attestation notarized, and return the completed affidavit to the Commonwealth.
Attestation
As a duly authorized representative for the Contractor, I swear and affirm under penalty of perjury, that that the Contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that the award of a contract will not violate any provision of the campaign finance laws of the Commonwealth. For purposes of this attestation, "Knowingly" means that the bidder or offeror is aware or should have been aware of the existence of a violation. The bidder or offer understands that the Commonwealth retains the right to request an updated affidavit at any time.
Signature Printed Name
Title Date
Bidder or Offeror Name: __________________________________________________________
Address: __________________________________________________________
Commonwealth of Kentucky Vendor Code (If known): _______________
Subscribed and sworn to before me this _____ day of _______________, ____________.
State of: ___________________ Notary: ___________________________________
County of: _________________ My Commission Expires: _____________________ https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22348 https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22349
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| Vendor Code: |
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| Notary Name: |
| County Name: |
| Commission Expiration Date: |
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