4-Vendors Statement Pursuant to KRS45A.343 Page - FINAL.pdf
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- Attached to
- Storm Sewer Culvert Inspection
- Solicitation number
- 4465
- Issued by
- Daviess County, Kentucky
About this file
This is a Vendor's Statement form pursuant to Kentucky Revised Statute (KRS) 45A.343, required by the City of Owensboro, Kentucky for contractors seeking to enter into contracts with the municipality. The form serves as a compliance certification wherein vendors must attest that they have not been found in violation of specified Kentucky statutes within the five-year period preceding submission. The statement covers 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 applicable provisions throughout the contract duration with the City of Owensboro.
The form establishes enforcement mechanisms and consequences for nondisclosure or noncompliance, including contract cancellation and disqualification from future City of Owensboro contracts for a period of two years. The statement requires completion and signature by a duly authorized officer of the vendor company, including company name, authorized representative name and title, and execution date. This document is a standard pre-contract requirement and does not contain information regarding pricing, contract value, performance schedules, or project-specific deliverables, as it functions solely as a compliance certification instrument for vendor eligibility determination.
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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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