_2023- Annual Required Affidavit for Bidders Offerors and Contractors.pdf
PDF 253 KB Posted
- Attached to
- DOCJT Bi-Annual Tree Trimming FY24
- Solicitation number
- RFQ-525-2300000135-1
- Issued by
- Madison County, Kentucky
About this file
This document is a Required Affidavit for Bidders, Offerors, and Contractors to be submitted to the Commonwealth of Kentucky when bidding on or renewing a contract. The affidavit attests that the bidder or offeror has not knowingly violated the Commonwealth's campaign finance laws, and that the award of a contract will not violate any provision of the campaign finance laws. The affidavit must be completed, notarized, and returned to the Commonwealth. The affidavit is effective for one year from the date of execution.
The document outlines the legal statutes that require this affidavit, KRS 45A.110 and 45A.115, and provides instructions for completing the attestation. It requires the signature of an authorized representative of the contracting party, as well as the printed name, title, and date. The bidder or offeror must also provide their name and address, as well as their Commonwealth of Kentucky Vendor Code if known. The notary section must be completed, including the state, county, notary name, and commission expiration date.
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| File | Type | Posted |
|---|---|---|
| Final_RFQ_525_2300000135_1_SO_FORM.PDF |
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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: |
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| Commission Expiration Date: |
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