Annual Affidavit Jan 2023.pdf
PDF 386 KB Posted
- Solicitation number
- RFB-605-2300000679-2
- Issued by
- Grant County, Kentucky
About this file
This document is a required affidavit for bidders, offerors, and contractors in the Commonwealth of Kentucky pursuant to KRS 45A.110 and 45A.115. The affidavit must be submitted and notarized when bidding on or renewing a contract with the Commonwealth. The affidavit attests that the contractor has not knowingly violated the campaign finance laws of the Commonwealth and that the award of a contract will not violate any provision of the campaign finance laws. The contractor must complete the attestation, have it notarized, and return the completed affidavit to the Commonwealth. The Commonwealth retains the right to request an updated affidavit at any time.
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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: _____________________
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