Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.pdf
PDF 150 KB Posted
- Attached to
- RoW Mow and Trim Butler Co
- Solicitation number
- RFB 605 2400000410 2
- Issued by
- Breckinridge County, Kentucky
About this file
This is a Required Affidavit form for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky, effective pursuant to Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. The affidavit must be completed and submitted by any bidder, offeror, or contractor seeking to be awarded a contract or contract renewal from the Commonwealth. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the completed form to the Commonwealth. The affidavit remains valid for one year from the date of execution. No specific products, services, project overviews, quantities, response dates, due dates, site visits, bidders' meetings, award dates, or contract terms are identified in this document, as it serves as a general compliance requirement form rather than a specific solicitation.
The attestation requires the authorized representative to swear under penalty of perjury that the contractor has not knowingly violated Kentucky campaign finance laws and that contract award will not violate any provision of those laws. "Knowingly" is defined as awareness or reasonable awareness of a violation's existence. The form requires the contractor's name, address, Commonwealth Vendor Code if available, the representative's signature, printed name, title, and date of execution. The attestation must be notarized, with the notary providing their signature, commission expiration date, and the state and county where notarization occurred. The Commonwealth retains the right to request an updated affidavit at any time during the contract term.
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Other files
| File | Type | Posted |
|---|---|---|
| How to Submit an Online Response - March 2023.pdf | ||
| WLS Butler Co Type II.xlsx | XLSX spreadsheet | |
| Drawings - Delineator Posts.pdf | ||
| Drawings with Trimming.pdf | ||
| Final_RFB_605_2400000410_2_SO_FORM.PDF | ||
| Drawing - Trimming of Bridge Embankments.pdf | ||
| Final_RFB_605_2400000410_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: _____________________ 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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