4-Vendors Statement Pursuant to KRS45A.343 Page - FINAL.pdf
PDF 174 KB Posted
- Attached to
- 2026 Spring Paving Project
- Solicitation number
- 4460
- Issued by
- Cumberland County, Kentucky
About this file
This is a Vendor's Statement form pursuant to Kentucky Revised Statutes (KRS) 45A.343, required by the City of Owensboro, Kentucky for contract compliance purposes. The document serves as a certification that prospective vendors have not violated applicable Kentucky statutes within the five-year period preceding the statement submission. The form requires vendors to affirm compliance with KRS Chapters 136 (Corporate Taxes), 139 (Sales and Use Taxes), 141 (Income Taxes), 337 (Wage and Hour), 338 (Occupational Safety), 341 (Unemployment), and 342 (Workers Compensation). Vendors must acknowledge their obligation to maintain compliance with these statutory provisions throughout the duration of any contract entered into with the City of Owensboro.
The form includes consequences for nondisclosure or noncompliance, authorizing the City of Owensboro to cancel contracts with non-compliant vendors and disqualify them from future contract eligibility for a two-year period. The document is a standardized template requiring completion with the vendor company name, authorized officer signature, title, and execution date. This statement is a prerequisite for contract award and reflects Kentucky's procurement requirements to ensure vendor accountability and statutory compliance before contract execution.
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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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