Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.docx
DOCX document 111 KB Posted
- Attached to
- Mats Service D10
- Solicitation number
- RFB-605-2400000018-1
- Issued by
- Breathitt County, Kentucky
About this file
This document is an Annual Affidavit for Bidders, Offerors and Contractors required by the Commonwealth of Kentucky pursuant to KRS 45A.110 and 45A.115. The affidavit must be completed, notarized, and submitted by any bidder, offeror, or contractor seeking to be awarded or renew a contract with the Commonwealth. The affidavit requires the authorized representative of the contracting party to attest that the contractor has not knowingly violated the 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. The affidavit is effective for one year from the date of execution.
The document does not contain any information about specific contract opportunities, products or services requested, response dates, award dates, or contract terms. It is solely focused on the attestation required for bidders, offerors, and contractors to be eligible for state contracts in the Commonwealth of Kentucky.
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Other files
| File | Type | Posted |
|---|---|---|
| How to Submit an Online Response - March 2023.pdf | ||
| Final_RFB_605_2400000018_1_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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