Annual Affidavit for Bidders, Offerors, and Contractors.pdf
PDF 78 KB Posted
- Attached to
- Grout and Backer Rod - FHWA Eligible - REBID
- Solicitation number
- RFB 605 2400000399 1
- Issued by
- Kentucky
About this file
This is an affidavit form required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking contract awards or renewals under Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. The affidavit serves as an annual certification effective for one year from the date of execution. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the completed affidavit to the Commonwealth to be eligible for contract award or renewal.
The affidavit requires the authorized representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky's campaign finance laws and that awarding the contract will not violate any provision of those laws. "Knowingly" is defined as awareness or reasonable awareness of a violation's existence. The Commonwealth retains the right to request updated affidavits at any time. The form requires completion of contractor identification information including name, address, and vendor code, along with the representative's signature, printed name, title, and execution date, followed by notarization with the notary's signature, commission expiration date, and the state and county where notarization occurs.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| BABA.pdf | ||
| FHWA.pdf | ||
| Final_RFB_605_2400000399_1_SO_FORM.PDF | ||
| How to Submit a Bid Online.pdf | ||
| Shipping Addresses for District Traffic Barns - 2-7-24.xml | XML file |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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: _____________________
File details come from the government source that posted it. Updated .