8-Vendors Statement Pursuant to KRS45A.pdf
PDF 153 KB Posted
- Attached to
- Moreland Avenue Concrete Street Reconstruction
- Solicitation number
- 4466
- Issued by
- Daviess 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 bidders and awardees. The document serves as a compliance certification where vendors must attest that they have not been found in violation of specified Kentucky statutes within the five-year period preceding the statement. The form requires vendors to acknowledge their obligation to maintain 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) throughout the duration of any contract awarded by the City of Owensboro. The statement must be signed by a duly authorized officer of the vendor and includes fields for company name, authorized representative signature, title, and date of execution.
The form establishes enforceable consequences for non-compliance or misrepresentation. Should a vendor fail to disclose any final determination of violation or fail to maintain compliance with applicable statutes during contract performance, the City of Owensboro is authorized to cancel the contract immediately and disqualify the vendor from eligibility for future city contracts for a period of two years. This certification requirement applies to the Moreland Avenue Concrete Street Reconstruction project in Owensboro, Kentucky, which involves removal and replacement of existing street, curb, ADA ramps, and sidewalk. All vendors responding to this procurement must complete and submit this compliance statement as part of their bid package.
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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 _____________________, 20___.
Company Name: ________________________________________________
By: ___________________________________________________________
Signature: _____________________________________________________
Title: ________________________________________________________
| To the best of my knowledge information and belief: |
| 2: |
| 3: |
| Cancel its contract with: |
| Disqualify: |
| This: |
| day of: |
| 20: |
| Company Name: |
| By: |
| Title: |
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