Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- Mats Service D10
- Solicitation number
- RFB 605 2400000018 1
- Issued by
- Hart County, Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors and Contractors mandated by the Commonwealth of Kentucky under KRS 45A.110 and 45A.115. The affidavit must be completed and notarized by an authorized representative of any bidder, offeror, or contractor seeking to be awarded a contract or contract renewal with the state. The attestation certifies that the contractor has not knowingly violated Kentucky's campaign finance laws and that contract award will not violate any provision of those laws. The affidavit is effective for one year from the date of execution, after which updated affidavits may be requested by the Commonwealth at any time. The document requires the bidder or offeror's name, address, and vendor code if known, along with the authorized representative's signature, printed name, title, and date.
The affidavit must be notarized before a notary public, with the notary providing their signature, the expiration date of their commission, and identifying the state and county where the notarization occurs. The term "knowingly" is defined to include violations of which the bidder or offeror is aware or should have been aware. This affidavit is a standard compliance requirement for all bidders and offerors on Kentucky state and local contracts and serves as an eligibility prerequisite for contract consideration.
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Other files
| File | Type | Posted |
|---|---|---|
| How to Submit an Online Response - March 2023.pdf | ||
| Final_RFB_605_2400000018_1_SO_FORM.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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