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

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Attached to
Truck Tool Boxes-REBID
Solicitation number
RFB 605 2400000016 2
Issued by
Elliott County, Kentucky

About this file

This is a Required Affidavit for Bidders, Offerors, and Contractors established by the Commonwealth of Kentucky pursuant to KRS 45A.110 and 45A.115. The affidavit is 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 submit the completed affidavit to the Commonwealth. The affidavit remains effective for one year from the date of execution, and the Commonwealth retains the right to request an updated affidavit at any time during or after contract performance.

The affidavit requires the contractor's authorized representative to attest under penalty of perjury that the contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that contract award will not violate any provision of Kentucky's campaign finance laws. For purposes of this attestation, "knowingly" is defined as awareness or should-have-been awareness of a violation's existence. The affidavit must include the contractor's signature, printed name, title, date of execution, bidder or offeror name, complete address, Commonwealth of Kentucky Vendor Code if known, notarization details including the notary's signature, commission expiration date, and the state and county where notarization occurred.

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Other files

File Type Posted
Final_RFB_605_2400000016_1_SO_FORM.PDF PDF
Final_RFB_605_2400000016_2_SO_FORM.PDF PDF
Bid Sheet.xlsx XLSX 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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