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

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Attached to
Guardrail Maintenance and Repair - D11 - Secondary
Solicitation number
RFB 605 2400000227 1
Issued by
Kentucky

About this file

This is an affidavit form required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking to be awarded or renew state contracts. The document, effective for one year from the date of execution, requires an authorized representative of the contracting party to complete an attestation, have it notarized, and return it to the Commonwealth. The affidavit pertains to compliance with Kentucky Revised Statutes 45A.110 and 45A.115 regarding campaign finance laws.

The attestation requires the authorized representative to swear under penalty of perjury that the contractor has not knowingly violated campaign finance laws of Kentucky 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 requires the bidder or offeror to provide their name, address, and Commonwealth of Kentucky Vendor Code if known. The Commonwealth retains the right to request an updated affidavit at any time during the contract period.

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Other files

File Type Posted
Final_RFB_605_2400000227_1_SO_FORM.PDF PDF
Vendor Bid Sheet.xls XLS spreadsheet
How to Submit an Online Response - March 2023.pdf 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: _____________________ 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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