Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- Janitorial Services: Boone Co. I-75 Rest Areas
- Solicitation number
- RFB 605 2300000796 2
- Issued by
- Boone 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 must be completed and notarized by an authorized representative of any bidder, offeror, or contractor seeking to be awarded a contract or renew an existing contract with the state. The attestation affirms under penalty of perjury that the contractor has not knowingly violated Kentucky campaign finance laws and that contract award will not violate any campaign finance law provisions. The affidavit remains valid for one year from the date of execution, after which time the Commonwealth may request an updated affidavit.
The document requires the contractor to provide identifying information including the bidder or offeror name, address, and Commonwealth of Kentucky vendor code if known. An authorized representative must sign the attestation, provide their printed name and title, and include the execution date. The completed affidavit must be notarized before a notary public, who must indicate the state and county where the notarization occurs, the date of notarization, and the expiration date of their commission. "Knowingly" is defined as the bidder or offeror being aware or should have been aware of a violation's existence.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_605_2300000796_1_SO_FORM.PDF | ||
| TC 71-126 revised Jan 2023.pdf | ||
| Disability Form.docx | DOCX document | |
| Final_RFB_605_2300000796_2_SO_FORM.PDF | ||
| How to Submit an Online Response - March 2023.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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