Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- Ferry Inspection and Preservation - Monroe Co
- Solicitation number
- RFB 605 2400000535 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 effective for one year from the date of execution and must be completed and notarized by an authorized representative of any bidder, offeror, or contractor seeking to be awarded a contract or renew an existing contract with the state. The document requires the authorized representative to attest under penalty of perjury that the contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that awarding the contract will not violate any provision of Kentucky's campaign finance laws. For purposes of this attestation, "knowingly" is defined as awareness or should-have-been awareness of a violation's existence.
The affidavit form requires completion of bidder or offeror information including legal name, address, and Commonwealth of Kentucky vendor code if known. The authorized representative must sign the attestation, provide their printed name and title, and include the date of execution. The completed affidavit must be notarized before a notary public, who must indicate the state and county where the oath is administered, the date of notarization, and the expiration date of their commission. The Commonwealth retains the right to request an updated affidavit at any time during the contract period. This affidavit is a prerequisite compliance document and does not address pricing, contract terms, or project scope.
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Other files
| File | Type | Posted |
|---|---|---|
| How to Submit an Online Response - March 2023.pdf | ||
| Final_RFB_605_2400000535_1_SO_FORM.PDF | ||
| Buy America-BABA.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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