Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Solicitation number
- RFB 605 2300000492 1
- Issued by
- Hardin County, Kentucky
About this file
This is an affidavit form required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking contract awards or contract renewals. The document, effective for one year from the date of execution, requires an authorized representative of the contracting party to attest under penalty of perjury that the contractor has not knowingly violated Kentucky's campaign finance laws and that awarding the contract will not violate any provision of those laws. The affidavit must be notarized and submitted to the Commonwealth prior to contract award. The Commonwealth retains the right to request updated affidavits at any time during the contract period.
The affidavit requires completion of basic contractor information including the bidder or offeror name, address, and Commonwealth of Kentucky vendor code if known. The authorized representative must provide a signature, printed name, and title, along with the date of execution. A notary public must then certify the affidavit by providing their signature, the date of notarization, their commission expiration date, and identifying the state and county where the notarization occurs. This attestation document serves as a compliance verification mechanism to ensure contractor eligibility under Kentucky's campaign finance regulations.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_605_2300000492_1_SO_FORM.PDF | ||
| How to Respond to Online Bid through Kentucky Vendor Self....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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