Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023 - Copy.docx
DOCX document 111 KB Posted
- Attached to
- Drill and Blasting D-11 FEDERAL
- Solicitation number
- RFB-605-2400000020-2
- Issued by
- Casey County, Kentucky
About this file
This document is a Required Affidavit for Bidders, Offerors, and Contractors that must be submitted to the Commonwealth of Kentucky in order to be awarded a contract or have a contract renewed. The affidavit requires the contractor to attest that they have not knowingly violated the Commonwealth's campaign finance laws, and that the award of a contract will not violate any provision of the campaign finance laws. The contractor must complete the affidavit, have it notarized, and submit it to the Commonwealth. The Commonwealth retains the right to request an updated affidavit at any time.
The affidavit does not provide any details about a specific contract opportunity, but rather outlines a general requirement for all contractors doing business with the Commonwealth of Kentucky. There are no details provided about products, services, quantities, response dates, award dates, contract terms, or renewal options.
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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: _____________________ |
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