Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- DEMOLITION KY 61
- Solicitation number
- RFB 605 2400000050 1
- Issued by
- Greenup County, Kentucky
About this file
This is an affidavit form required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking to be awarded state contracts or contract renewals. The document, effective for one year from the date of execution, is mandated under Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the affidavit to the Commonwealth before contract award or renewal can proceed.
The affidavit requires the authorized representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky campaign finance laws and that contract award will not violate any provision of such laws. "Knowingly" is defined as awareness or should-have-been awareness of a violation's existence. The form includes fields for the bidder or offeror name, address, Commonwealth of Kentucky vendor code, contractor representative signature, printed name, title, and date, along with notarization requirements including the notary's signature, commission expiration date, state, and county. The Commonwealth retains the right to request an updated affidavit at any time during the contract term.
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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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