Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- DEMOLITION Breathitt Co. 10-0376. 00 P. 22
- Solicitation number
- RFB-605-2300000771-3
- Issued by
- Breckinridge County, Kentucky
About this file
This document is the Required Affidavit for Bidders, Offerors, and Contractors for the Commonwealth of Kentucky. It is required for any bidder, offeror, or contractor to be awarded or renew a contract with the Commonwealth. The affidavit attests that the contractor has not knowingly violated the 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. The affidavit must be completed, notarized, and returned to the Commonwealth. The Commonwealth retains the right to request an updated affidavit at any time.
The affidavit does not contain any information about a specific contract opportunity, products, services, quantities, response dates, award dates, or contract terms. It is a standardized affidavit required for all contract awards and renewals with the Commonwealth of Kentucky.
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Other files
| File | Type | Posted |
|---|---|---|
| 10-0376.00 PLAN PAGE.pdf | ||
| Final_RFB_605_2300000771_3_SO_FORM.PDF | ||
| Final_RFB_605_2300000771_2_SO_FORM.PDF | ||
| How to Submit an Online Response - March 2023.pdf | ||
| Bid Sheet - Demo.xlsx | XLSX spreadsheet | |
| Final_RFB_605_2300000771_1_SO_FORM.PDF | ||
| 10-0376.00 IMPROVEMENT PHOTOS.pdf | ||
| 10-0376.00 AERIAL.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: _____________________ |
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