Annual Affidavit Jan 2023.pdf
PDF 386 KB Posted
- Attached to
- Retrofit Snow Single Axle Campbell Co
- Solicitation number
- RFB 605 2400000204 1
- Issued by
- Campbell County, Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky pursuant to KRS 45A.110 and 45A.115. The affidavit is effective for one year from the date of execution and must be completed by an authorized representative of any bidder, offeror, or contractor seeking to be awarded a contract or renewal of a contract with the state. The form requires the contractor's authorized representative to attest under penalty of perjury that the contractor has not knowingly violated campaign finance laws of Kentucky and that the contract award will not violate any provision of Kentucky's campaign finance laws. The affidavit must be notarized and returned to the Commonwealth prior to contract award.
The affidavit document contains specific attestation language defining "knowingly" as awareness or reasonable awareness of a violation. The form includes fields for the contractor's signature, printed name, title, and date of execution, along with the bidder or offeror's legal name, address, and Commonwealth of Kentucky vendor code if known. The notary section requires the notary's signature, commission expiration date, and identification of the state and county where the affidavit is sworn. The Commonwealth retains the right to request an updated affidavit at any time during the contract period.
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Other files
| File | Type | Posted |
|---|---|---|
| Truck Retrofitters.pdf | ||
| District Map.pdf | ||
| Drawing Hopper Lights - Revised May 2013.pdf | ||
| Drawings.pdf | ||
| Bid Sheets 2023-2024 Single Axle D6 Campbell.xlsx | XLSX spreadsheet | |
| How to Submit an Online Response - March 2023.pdf | ||
| Final_RFB_605_2400000204_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: _____________________
File details come from the government source that posted it. Updated .