Annual Affidavit for Bidders, Offerors and Contractors.pdf
PDF 150 KB Posted
- Solicitation number
- RFP 605 2600000117 1
- Issued by
- Elliott County, Kentucky
About this file
This is a Required Affidavit form for Bidders, Offerors, and Contractors established by the Commonwealth of Kentucky pursuant to Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. The affidavit is mandatory for all bidders, offerors, and contractors seeking to be awarded a contract or renewal of an existing contract with the Commonwealth. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the completed form to the Commonwealth. The affidavit is effective for one year from the date of execution.
The attestation requires the authorized representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky's campaign finance laws and that contract award will not violate any campaign finance law provisions. "Knowingly" is defined as awareness or should-have-been awareness of a violation's existence. The form requires completion of bidder or offeror information including name, address, and Kentucky Vendor Code if known, along with the representative's signature, printed name, title, and date. Notarization must include the notary's signature, commission expiration date, state, and county. The Commonwealth retains the right to request an updated affidavit at any time during the contract period.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFP_605_2600000117_1_SO_FORM.PDF | ||
| How to Submit an Online Response - March 2023.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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