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

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Attached to
Janitorial Services: Oldham Co. I-71 Rest Areas
Solicitation number
RFB 605 2300000781 3
Issued by
Morgan County, 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 serves as a mandatory submission requirement for any entity seeking to be awarded a state contract or renew an existing contract with Kentucky. The document requires an authorized representative of the bidding or contracting party to complete the attestation, obtain notarization, and submit the signed and sworn affidavit to the Commonwealth. The affidavit is effective for one year from the date of execution.

The attestation requires the authorized 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 should-have-been awareness of a violation's existence. Bidders and offerors must acknowledge that the Commonwealth retains the right to request an updated affidavit at any time. The submission requires completion of contractor identification information including name, address, and Commonwealth of Kentucky Vendor Code if known, along with notarization details including the notary's name, state and county location, commission expiration date, and date of notarization.

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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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