Annual Affidavit for Bidders, Offerors, and Contractors.pdf

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Attached to
Grout and Backer Rod - FHWA Eligible - REBID 2
Solicitation number
RFB 605 2400000520 1
Issued by
Kentucky

About this file

This is an Annual Affidavit for Bidders, Offerors, and Contractors required by the Commonwealth of Kentucky under KRS 45A.110 and 45A.115. The affidavit is a mandatory submission requirement for any entity seeking to be awarded a state contract or to renew an existing contract with the Commonwealth. An authorized representative of the bidding or contracting party must complete the attestation, obtain notarization, and submit it to the Commonwealth. The affidavit remains effective for one year from the date of execution, after which an updated affidavit may be required by the Commonwealth at any time.

The attestation 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 provision of those laws. For purposes of the affidavit, "knowingly" is defined as awareness or the reasonable expectation of awareness regarding the existence of any violation. The document includes fields for the contractor's signature, printed name, title, date of execution, bidder or offeror name, address, Commonwealth of Kentucky vendor code, notary information including the notary's signature, commission expiration date, and the state and county where the affidavit was notarized.

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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: _____________________

File details come from the government source that posted it. Updated .