Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.pdf
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- Attached to
- Used Railroad Rail D5 - Spencer Co
- Solicitation number
- RFB 605 2400000586 2
- Issued by
- Spencer County, Kentucky
About this file
This is an Annual Affidavit form required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking to be awarded or renew state contracts. The affidavit is mandated under Kentucky Revised Statutes (KRS) 45A.110 and 45A.115 and remains effective for one year from the date of execution. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the completed form to the Commonwealth. The form requires submission prior to contract award or renewal.
The affidavit requires the contractor's authorized representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky's campaign finance laws and that accepting a contract award will not violate any provision of those laws. "Knowingly" is defined as awareness or reasonable awareness of a violation's existence. The Commonwealth reserves the right to request updated affidavits at any time during the contract period. The form collects basic contractor information including name, address, and Kentucky Vendor Code if available, and must be notarized with the notary's commission expiration date noted.
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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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