Annual Required Affidavit for Bidders Offerors and Contractors.pdf
PDF 253 KB Posted
- Attached to
- Janitorial Services for Prestonsburg Office
- Solicitation number
- RFQ 040 2700000006 1
- Issued by
- Kentucky
About this file
This is a Required Affidavit form for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky pursuant to Kentucky Revised Statutes 45A.110 and 45A.115. The affidavit applies to the Janitorial Services for Prestonsburg Office contract opportunity in Kentucky. The form requires an authorized representative of the contracting party to complete an attestation, have it notarized, and submit it to the Commonwealth. The attestation confirms that the contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that award of the contract will not violate any provision of Kentucky's campaign finance laws. The affidavit is effective for one year from the date of execution.
The form requires the contractor to provide identifying information including the bidder or offeror name, address, and vendor code if known. An authorized representative must sign the attestation and provide their printed name, title, and date. The form must be notarized before a notary public who must provide their name, state and county information, and commission expiration date. The Commonwealth retains the right to request an updated affidavit at any time during the contracting process or contract term.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Prestonsburg Office Floor Plan.pdf | ||
| Final_RFQ_040_2700000006_1_SO_FORM.PDF |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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
| Date: |
| Signature: |
| Title: |
| Printed Name: |
| Bidder or Offeror Name: |
| Address Line 1: |
| Address Line 2: |
| Address Line 3: |
| Vendor Code: |
| Day: |
| Month: |
| Year: |
| State: |
| Notary Name: |
| County Name: |
| Commission Expiration Date: |
File details come from the government source that posted it. Updated .