3-Vendors Statement Pursuant to KRS45A.343 Page - FINAL.pdf
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- Attached to
- Semi-Automated Side Loader
- Solicitation number
- 4443
- Issued by
- Daviess County, Kentucky
About this file
This is a vendor compliance statement form required by the City of Owensboro, Kentucky pursuant to KRS 45A.343, which mandates that vendors disclose any violations of specific Kentucky Revised Statutes chapters and commit to ongoing compliance during contract performance. The form requires vendors to certify they have not been finally determined to have violated provisions of KRS Chapters 136 (Corporate taxes), 139 (Sales & use taxes), 141 (Income taxes), 337 (Wage and hour), 338 (Occupational safety), 341 (Unemployment), or 342 (Workers Compensation) within the five-year period preceding the statement. The document is dated for 2025 and includes blank fields for company information, authorized officer signature, and notarization.
The form establishes that vendors must maintain compliance with all applicable provisions of the specified statutes for the entire duration of their contract with the City of Owensboro. Failure to disclose any final determinations of violations or to maintain compliance during the contract term will result in contract cancellation and disqualification from future city contracts for a two-year period. This compliance statement serves as a mandatory prerequisite for contract award and creates ongoing legal obligations for vendors throughout the contract performance period.
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Text version
VENDOR’S STATEMENT PURSUANT TO KRS45A.343
45A.343 Local Public Agency may adopt provisions of KRS 45A.345 to 45A.460— Effect of adoption – Contracts required to mandate revealing of violations of and compliance with specified KRS chapters – Effect of nondisclosure or noncompliance.
(KRS 136 – Corporate taxes; KRS 139 – Sales & use taxes; KRS 141 – Income taxes;
KRS 337 – Wage and hour; KRS 338 – Occupational safety; KRS 341 – Unemployment;
KRS 342 – Workers Comp.)
The undersigned, as a duly authorized officer of ______________________________________ pursuant to KRS45A.343 states;
1. To the best of my knowledge, information and belief, ____________________________ has not been finally determined to have violated any of the provisions of KRS Chapters
136, 139, 141, 337, 338, 341, or 342 that apply to it within the five year period preceding this statement.
2. __________________________________________ acknowledges that it will be required to be in compliance with those provisions of KRS Chapters 136, 139, 141, 337, 338, 341, and 342 that apply to it for the duration of the Contract to be entered into with the City of Owensboro, Kentucky.
3. __________________________________________ acknowledges that if it fails to reveal any final determination of violation of KRS Chapters 136, 139, 141, 337, 338, 341, or 342, or to comply with the applicable provisions of those statutes for the duration of the aforesaid Contract, such shall be grounds for The City of Owensboro, Kentucky to:
a. Cancel its contract with___________________________________________, and
b. Disqualify _______________________________________________from eligibility for future contracts awarded by The City of Owensboro for a period of two years.
This _______ day of _____________________, 2025.
Company Name: ________________________________________________
By: ___________________________________________________________
Signature: _____________________________________________________
Title: ________________________________________________________
| The undersigned as a duly authorized officer of: |
| To the best of my knowledge information and belief: |
| 2: |
| 3: |
| Cancel its contract with: |
| Disqualify: |
| This: |
| day of: |
| Company Name: |
| By: |
| Title: |
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