Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- Janitorial Services: Clark Co. I-64 Rest Area
- Solicitation number
- RFB 605 2300000787 3
- Issued by
- Casey County, 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 is effective for one year from the date of execution and must be submitted by all bidders, offerors, or contractors to be awarded a contract or for the renewal of an existing contract. An authorized representative of the contracting party must complete the attestation, have it notarized, and return the completed affidavit to the Commonwealth of Kentucky.
The attestation requires that an 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 these laws. For purposes of this attestation, "knowingly" means the bidder or offeror is aware or should have been aware of the existence of a violation. The Commonwealth retains the right to request an updated affidavit at any time. The completed affidavit must include the contractor's signature, printed name, title, date of execution, bidder or offeror name and address, Commonwealth of Kentucky vendor code if known, notarization details including the state and county where notarized, the notary's signature, and the notary's commission expiration date.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_605_2300000787_2_SO_FORM.PDF | ||
| Final_RFB_605_2300000787_1_SO_FORM.PDF | ||
| Final_RFB_605_2300000787_3_SO_FORM.PDF | ||
| Disability Form.docx | DOCX document | |
| TC 71-126 revised Jan 2023.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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