Affidavit_Regarding_Worker's_Compensation.docx

DOCX document 46 KB Posted

Attached to
Runway 18L/36R Tunnel Rehabilitation & Safety Improvements
Solicitation number
26-045-ITB
Issued by
Kenton County, Kentucky

About this file

This is an Affidavit Regarding Worker's Compensation form required by the Kenton County Airport Board, operator of the Cincinnati/Northern Kentucky International Airport in Kentucky. The affidavit serves as a compliance assurance document that must be executed by contractors awarded contracts for the Runway 18L/36R Tunnel Rehabilitation & Safety Improvements project. The form requires the contractor to affirm that all contractors and subcontractors employed under the contract will maintain compliance with Kentucky's worker's compensation insurance requirements as specified in KRS Chapter 342 and unemployment insurance requirements under KRS Chapter 341. A pre-proposal meeting and site visit for the project are scheduled for Wednesday, August 19, 2026 at 1:00 pm at CVG Centre, 77 Comair Blvd., Erlanger, KY 41048. Questions must be submitted by 11:59 pm on Monday, August 24, 2026, with answers to be posted no later than Friday, August 28, 2026 at 11:59 pm. Proposals are due by Thursday, September 3, 2026 at 2:00 pm, with no proposals accepted after that deadline unless an addendum extends the date or time.

The affidavit must be signed by an authorized representative of the contractor and notarized before a notary public. This document is a mandatory submission requirement for contract award and demonstrates the contractor's commitment to maintaining statutory compliance with Kentucky labor and insurance regulations throughout the performance of the contract.

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Text version

KENTON COUNTY AIRPORT BOARD CINCINNATI/NORTHERN KY INTERNATIONAL AIRPORT

PROJECT NAME

AFFIDAVIT REGARDING WORKER'S COMPENSATION

The undersigned Contractor, being awarded a Contract by the Kenton County Airport Board, operator of the Cincinnati/Northern Kentucky International Airport, identified as: ________________________________ hereby assures that all Contractors and subcontractors employed, or that will be employed, under the provisions of the foregoing identified contract shall be in compliance with Kentucky requirements for Worker's Compensation Insurance according to KRS Chapter 342 and unemployment insurance according to KRS Chapter 341.

DATED this day of , 20____.

Signature: ___________________________________________________

Name and Title (Printed):

STATE OF

COUNTY OF

Subscribed and sworn to before me, a Notary Public, by ________ , on behalf of the foregoing identified Contractor this day of ____ 20 .

Notary Public

My Jurisdiction is:

My Commission Expires:

END OF SECTIO

File details come from the government source that posted it. Updated .