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

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Attached to
DEMOLITION Breathitt Co. P. 5 & 7
Solicitation number
RFB 605 2300000750 1
Issued by
Breathitt County, Kentucky

About this file

This is a Required Affidavit for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky pursuant to KRS 45A.110 and 45A.115. The affidavit is mandatory for any bidder, offeror, or contractor seeking to be awarded a contract or renew an existing contract with the Commonwealth. An authorized representative of the contracting party must complete the attestation, have it notarized, and submit it to the Commonwealth. The affidavit is effective for one year from the date of execution and must be renewed annually or upon contract renewal. The document requires submission of contractor information including the bidder or offeror name, address, and Commonwealth vendor code if available, along with notarization details including the notary's commission expiration date.

The affidavit requires the authorized representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky campaign finance laws and that awarding the contract will not violate any provision of those laws. "Knowingly" is defined as awareness or constructive awareness of a violation's existence. The Commonwealth reserves the right to request an updated affidavit at any time during the contract period. This attestation serves as a compliance mechanism to ensure bidders and contractors meet state campaign finance requirements before contract award or renewal.

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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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