Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.pdf
PDF 150 KB Posted
- Solicitation number
- RFB-605-2400000694-1
- Issued by
- Clay County, Kentucky
About this file
This document is an "Annual Affidavit for Bidders, Offerors and Contractors" required by the Commonwealth of Kentucky under KRS 45A.110 and 45A.115. It must be completed, notarized, and submitted by any contractor seeking to be awarded or renew a contract with the Commonwealth. The affidavit attests that the contractor has not knowingly violated the Commonwealth's campaign finance laws and that the award of a contract will not violate any provision of the campaign finance laws.
The related state and local contract opportunity is for a one-time contract for the supply of Sodium Chloride (road salt) to Clay County, Kentucky. No other details about the contract, such as quantities, pricing, or award dates, are provided in the document.
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Other files
| File | Type | Posted |
|---|---|---|
| How to Submit an Online Response - March 2023.pdf | ||
| Final_RFB_605_2400000694_1_SO_FORM.PDF | ||
| eBridge Information.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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