3-Vendors Statement Pursuant to KRS45A.343 Page - UPLOAD.pdf
PDF 174 KB Posted
- Attached to
- 2026 Drone Show
- Solicitation number
- 4454
- Issued by
- Daviess County, Kentucky
About this file
This is a Vendor's Statement form required by the City of Owensboro, Kentucky, pursuant to KRS 45A.343, mandating vendor disclosure and compliance with specified Kentucky Revised Statutes. The form requires vendors entering into contracts with the City of Owensboro to certify that they have not been found in violation of Kentucky statutes governing corporate taxes (KRS 136), sales and use taxes (KRS 139), income taxes (KRS 141), wage and hour laws (KRS 337), occupational safety (KRS 338), unemployment insurance (KRS 341), and workers' compensation (KRS 342) within the five-year period preceding the statement. Vendors must acknowledge their obligation to maintain compliance with these applicable statutes throughout the duration of their contract with the City of Owensboro.
The form contains critical consequences for noncompliance or nondisclosure of violations. Any vendor that fails to disclose final determinations of violations or fails to comply with applicable statutory provisions during contract performance exposes itself to contract cancellation by the City of Owensboro and disqualification from future City contracts for a period of two years. The document provides blank spaces for the vendor to enter company name, authorized officer signature, title, and date of execution, with the form dated for 2025. This certification represents a mandatory compliance prerequisite for participation in City of Owensboro procurement opportunities.
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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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