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

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Attached to
Bridge Planking for D-1 Structures Rebid
Solicitation number
RFB 605 2300000487 1
Issued by
Kentucky

About this file

This is a Required Affidavit for Bidders, Offerors and Contractors issued by the Commonwealth of Kentucky under KRS 45A.110 and 45A.115. The affidavit serves as a mandatory compliance document that all bidders, offerors, and contractors must submit to be awarded a contract or for contract renewal. An authorized representative of the contracting party must complete the attestation, obtain notarization, and return the executed affidavit to the Commonwealth. The affidavit remains effective for one year from the date of execution, and the Commonwealth retains the right to request updated affidavits at any time during the contract period.

In the attestation, the authorized representative swears under penalty of perjury that the contractor has not knowingly violated Kentucky's campaign finance laws and that contract award will not violate any provision of those laws. For purposes of this affidavit, "knowingly" is defined as awareness or should-have-been awareness of a violation's existence. The affidavit requires the contractor to provide the bidder or offeror name, address, and Commonwealth vendor code if known, along with the notary's signature, commission expiration date, and the specific date and location where the oath was administered.

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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: _____________________ https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22348 https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=22349

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