Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx

DOCX document 111 KB Posted

Attached to
DEMOLITION Ballard Co
Solicitation number
RFB 605 2300000542 1
Issued by
Anderson County, Kentucky

About this file

This is an annual affidavit document required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking to be awarded or renew state contracts. The affidavit, effective for one year from the date of execution and governed by Kentucky Revised Statutes (KRS) 45A.110 and 45A.115, must be completed by an authorized representative of the contracting party, notarized, and submitted to the Commonwealth prior to contract award or renewal. No specific products, services, project timelines, quantities, response dates, bidders' conferences, or award dates are outlined in this document, as it serves as a template for attestation rather than a specific solicitation notice.

The affidavit requires the authorized contractor 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 provision of those laws. The term "knowingly" is defined as awareness or constructive awareness of a violation. The document includes fields for the contractor's signature, printed name, title, date of execution, bidder or offeror name, address, and Commonwealth vendor code. The affidavit must be notarized with the notary's signature, commission expiration date, state, and county information documented. The Commonwealth retains the right to request updated affidavits at any time during the contract term.

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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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