Annual Affidavit for Bidders, Offerors and Contractors.pdf

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Attached to
Request for Proposals, KY Safe Teen Driving Challenge
Solicitation number
RFP-605-2500000355-1
Issued by
Kentucky

About this file

This document is a Required Affidavit for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky, specifically related to Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. The affidavit is a mandatory form that must be completed, signed, and notarized by an authorized representative of a contractor, bidder, or offeror seeking to be awarded or renew a contract with the Commonwealth. The affidavit is valid for one year from the date of execution and requires the contractor to attest that they have not knowingly violated campaign finance laws.

The affidavit serves as a legal declaration that the contractor understands and will comply with Kentucky's campaign finance regulations. The form requires the bidder or offeror to provide their name, address, and Commonwealth of Kentucky Vendor Code (if known). A notary must also complete the bottom section, documenting the date of execution, state and county of signing, and the notary's commission expiration date. The Commonwealth retains the right to request an updated affidavit at any time, and the contractor acknowledges that "knowingly" means they are or should be aware of any potential violations.

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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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