Annual Affidavit for Bidders Offerors and Contractors.pdf

PDF 98 KB Posted

Attached to
Utility pole replacement at Bluegrass Station
Solicitation number
RFQ-095-2400000024-1
Issued by
Fayette County, Lexington-Fayette Urban County, Kentucky

About this file

This document is a required affidavit for bidders, offerors, and contractors interested in being awarded a contract with the Commonwealth of Kentucky. It attests that the contracting party has not knowingly violated campaign finance laws of Kentucky and that the award of a contract will not violate any provision of the Commonwealth's campaign finance laws. The affidavit must be completed by an authorized representative of the contracting party, notarized, and submitted to the Commonwealth. The affidavit is effective for one year from the date of execution and the Commonwealth retains the right to request an updated affidavit at any time.

The document cites the relevant Kentucky Revised Statutes (KRS 45A.110 and 45A.115) that require this affidavit to be submitted prior to being awarded a contract or for the renewal of a contract with the Commonwealth. No other details regarding pricing, set-asides, funding, or the contract itself are provided in this document.

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File Type Posted
Agency Request For Quotation.pdf PDF
Final_RFQ_095_2400000024_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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