Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.pdf
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- Attached to
- RoW Mow ONLY Simpson Co D-3
- Solicitation number
- RFB 605 2300000481 1
- Issued by
- Ohio County, Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors and Contractors mandated by the Commonwealth of Kentucky under KRS 45A.110 and 45A.115. The affidavit must be completed and notarized by an authorized representative of any bidder, offeror, or contractor seeking to be awarded a contract or renew an existing contract with the Commonwealth. The affidavit is effective for one year from the date of execution. Bidders and offerors must attest under penalty of perjury that the contracting party has not knowingly violated Kentucky campaign finance laws and that the award of a contract will not violate any provision of those laws. For purposes of the attestation, "knowingly" is defined as the bidder or offeror being aware or should have been aware of the existence of a violation.
The Commonwealth of Kentucky retains the right to request an updated affidavit at any time during the contract period. Completion of the form requires the contractor's authorized representative to provide their signature, printed name, title, and date, along with the bidder or offeror's legal name, complete address, and Commonwealth of Kentucky Vendor Code if known. The form must be notarized before a notary public, with the notary providing their signature, commission expiration date, and identifying the state and county where the notarization occurs.
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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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