_2023- Annual Required Affidavit for Bidders Offerors and Contractors.pdf

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Attached to
KYPCIS Catering Lexington FY24
Solicitation number
RFQ-525-2300000127-1
Issued by
Fayette County, Madison County, Kentucky

About this file

This document is a Required Affidavit for Bidders, Offerors, and Contractors that must be completed and submitted pursuant to KRS 45A.110 and 45A.115 in order to be awarded a contract or for the renewal of a contract with the Commonwealth of Kentucky. The affidavit requires an authorized representative of the contracting party to attest under penalty of perjury that the contractor has not knowingly violated the Commonwealth's campaign finance laws. The affidavit must be completed, notarized, and returned to the Commonwealth. It is effective for one year from the date of execution.

The document outlines the specific statutory references and legal requirements related to the affidavit. It provides instructions for completing the attestation, which includes providing the contractor's name, address, and Commonwealth of Kentucky vendor code (if known). The notary information, including the state, county, and commission expiration date, must also be provided.

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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

Date:
Signature:
Title:
Printed Name:
Bidder or Offeror Name:
Address Line 1:
Address Line 2:
Address Line 3:
Vendor Code:
Day:
Month:
Year:
State:
Notary Name:
County Name:
Commission Expiration Date:

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