Annual Affidavit for Bidders, Offerors and Contractors.pdf
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- Solicitation number
- RFP 605 2500000355 1
- Issued by
- Elliott County, Kentucky
About this file
This is an Annual Affidavit form required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking to be awarded contracts or contract renewals under Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. The affidavit serves as a mandatory attestation that must be completed, notarized, and submitted by an authorized representative of the contracting party prior to contract award. The affidavit is effective for one year from the date of execution. Key procedural requirements include obtaining notarization of the completed form and returning it to the Commonwealth, with the Commonwealth retaining the right to request updated affidavits at any time during the contract period.
The affidavit requires the authorized representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky campaign finance laws and that awarding the contract will not violate any campaign finance law provisions. For purposes of the attestation, "knowingly" is defined as awareness or should-be awareness of a violation's existence. The form requires completion of contractor identification information including name, address, and Commonwealth vendor code if available, along with notarization details and the notary's commission expiration date. No pricing, set-asides, or funding information is contained within this document, as it functions solely as a compliance certification requirement applicable to all bidders and contractors engaging with the Commonwealth of Kentucky.
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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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