Annual Affidavit for Bidders Offerors and Contractors.pdf

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Attached to
H-structure pole and transformer bank change out
Solicitation number
RFQ-095-2400000049-1
Issued by
Fayette County, Lexington-Fayette Urban County, Kentucky

About this file

This document is an "Annual Affidavit for Bidders, Offerors and Contractors" required by the Commonwealth of Kentucky. It must be completed by any bidder, offeror, or contractor to be awarded a contract or for the renewal of a contract. The affidavit attests that the contractor has not knowingly violated the 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. The affidavit must be signed by an authorized representative of the contractor, notarized, and returned to the Commonwealth.

The related state and local contract opportunity is for an "H-structure pole and transformer bank change out" project located in Fayette County and the Lexington-Fayette Urban County area of Kentucky. No additional details about the project, such as quantities, response dates, or term of the contract, are provided in the document.

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File Type Posted
Agency Request For Quotation.pdf PDF
Final_RFQ_095_2400000049_1_SO_FORM.PDF 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: _____________________ https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22348 https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22349

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