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

DOCX document 111 KB Posted

Attached to
Metal Road Sign Blanks
Solicitation number
RFB 605 2400000276 2
Issued by
Elliott County, Kentucky

About this file

This is an annual affidavit document required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking to be awarded or renew state contracts. As mandated by Kentucky Revised Statutes (KRS) 45A.110 and 45A.115, an authorized representative of the contracting party must complete, notarize, and submit this attestation to the Commonwealth prior to contract award or renewal. The affidavit is effective for one year from the date of execution. No specific products, services, project timelines, bidder meetings, or contract terms are detailed in this document, as it serves as a general compliance requirement applicable across multiple contract opportunities.

The affidavit requires the contractor's authorized representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky campaign finance laws and that the contract award will not violate any provision of such laws. "Knowingly" is defined as awareness or should-be awareness of a violation's existence. The document requires the bidder or offeror's name, address, and Commonwealth vendor code. The Commonwealth reserves the right to request an updated affidavit at any time during the contract period. This document contains no pricing information, set-asides, incumbent details, or funding sources, as it functions solely as a certification requirement for contract eligibility.

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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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