Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- Aviation Upgrade
- Solicitation number
- RFB 605 2300000651 2
- Issued by
- Elliott County, Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors and Contractors document issued by the Commonwealth of Kentucky pursuant to 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 to renew an existing contract with the state. The affidavit requires attestation that the contractor has not knowingly violated Kentucky's campaign finance laws and that the contract award will not violate any provisions of those laws. "Knowingly" is defined as awareness or should-have-been awareness of a violation's existence.
The document requires submission of the completed and notarized affidavit to the Commonwealth prior to contract award. The attestation must include the contractor's signature, printed name, and title, along with the date of execution, bidder or offeror name, address, and Commonwealth of Kentucky vendor code if known. Notarization must be completed before a notary public, with documentation of the notary's name, commission expiration date, and the state and county where the affidavit was sworn. The Commonwealth retains the right to request an updated affidavit at any time during the contract period.
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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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