Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- Furnish and Install Thermo
- Solicitation number
- RFB 605 2300000465 3
- Issued by
- Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky pursuant to KRS 45A.110 and 45A.115. The affidavit must be submitted by any bidder, offeror, or contractor seeking to be awarded a contract or for the renewal of an existing contract with the Commonwealth of Kentucky. An authorized representative of the contracting party is required to complete the attestation, have it notarized, and return the completed affidavit to the Commonwealth. The affidavit is effective for one year from the date of execution.
The attestation requires that the authorized representative swear and affirm under penalty of perjury 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 campaign finance laws. For purposes of this attestation, "knowingly" is defined as awareness or reasonable awareness of the existence of a violation. The affidavit must include the contractor's name, address, Commonwealth of Kentucky vendor code if known, signature of the authorized representative with printed name and title, date of execution, notarization by a notary public including the state and county where notarized, and the notary's commission expiration date. The Commonwealth retains the right to request an updated affidavit at any time during the contract period.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_605_2300000465_1_SO_FORM.PDF | ||
| Bid Sheet.xlsx | XLSX spreadsheet | |
| How to Respond to Online Bid through Kentucky Vendor Self....pdf | ||
| Final_RFB_605_2300000465_2_SO_FORM.PDF | ||
| Final_RFB_605_2300000465_3_SO_FORM.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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