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

PDF 150 KB Posted

Attached to
Pest Control District 7
Solicitation number
RFB-605-2500000130-1
Issued by
Anderson County, Kentucky

About this file

This document is an Annual Affidavit for Bidders, Offerors and Contractors required by the Commonwealth of Kentucky pursuant to KRS 45A.110 and 45A.115. It mandates that any bidder, offeror, or contractor ("Contractor") seeking a contract award or renewal in the Commonwealth must attest that they have not knowingly violated campaign finance laws. The Contractor's authorized representative must complete the attestation, have it notarized, and submit it to the Commonwealth. The Commonwealth retains the right to request an updated affidavit at any time.

The document does not provide details on any specific contract opportunity. It outlines the affidavit requirement and the penalty of perjury that the Contractor faces for knowingly making a false statement. The affidavit is effective for one year from the date of execution.

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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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