Annual Affidavit for Bidders Offerors and Contractors-2.pdf
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- Attached to
- Isolators-FHWA Eligible-REBID
- Solicitation number
- RFB 605 2500000390 1
- Issued by
- Kentucky
About this file
This is an Annual Affidavit for Bidders, Offerors and Contractors required by the Commonwealth of Kentucky under KRS 45A.110 and 45A.115. The affidavit is a mandatory submission document for any bidder, offeror, or contractor seeking to be awarded a contract or contract renewal with the state of Kentucky. An authorized representative of the contracting party must complete, notarize, and return the affidavit to the Commonwealth prior to contract award. The affidavit is effective for one year from the date of execution.
The attestation requires the authorized contractor representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky campaign finance laws and that the contract award will not violate any provision of those laws. "Knowingly" is defined as awareness or reasonable awareness of a violation's existence. The affidavit form requires the contractor's signature, printed name, title, date, organization name, address, and Kentucky vendor code if known. The document must be notarized with the notary's signature, commission expiration date, state, and county. The Commonwealth retains the right to request updated affidavits at any time during the contract term.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_605_2500000390_1_SO_FORM.PDF | ||
| How to Submit a Bid Online - March 2023-2.pdf |
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Text version
Rev. 9-16-22
Required Affidavit for Bidders, Offerors and Contractors
(KRS 45A.110 & 45A.115)
Affidavit Effective for One (1) Year from Date of Execution
Instructions: Pursuant to KRS 45A.110 and 45A.115, a bidder, offeror, or contractor (“Contractor”) is required to submit a Required Affidavit for Bidders, Offerors, and Contractors to be awarded a contract, or for the renewal of a contract. An authorized representative of the contracting party must complete the attestation below, have the attestation notarized, and return the completed affidavit to the Commonwealth.
Attestation
As a duly authorized representative for the Contractor, I swear and affirm under penalty of perjury, that that the Contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that the award of a contract will not violate any provision of the campaign finance laws of the Commonwealth. For purposes of this attestation, "Knowingly" means that the bidder or offeror is aware or should have been aware of the existence of a violation. The bidder or offer understands that the Commonwealth retains the right to request an updated affidavit at any time.
Signature Printed Name
Title Date
Bidder or Offeror Name: __________________________________________________________
Address: __________________________________________________________
Commonwealth of Kentucky Vendor Code (If known): _______________
Subscribed and sworn to before me this _____ day of _______________, ____________.
State of: ___________________ Notary: ___________________________________
County of: _________________ My Commission Expires: _____________________
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