ATTACHMENT A - Annual Affidavit for Bidders, Offerors and Contractors - Jan 2023.pdf
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- Attached to
- ENGINEERING TRAINING FY 27-28
- Solicitation number
- RFP-605-2600000097-2
- Issued by
- Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky pursuant to Kentucky Revised Statutes (KRS) 45A.110 and 45A.115, applicable to the Engineering Training FY 27-28 contract opportunity. The affidavit must be completed by an authorized representative of any bidder, offeror, or contractor seeking to be awarded a contract or contract renewal with the state. The form requires the authorized representative to attest under penalty of perjury that the contracting party has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that contract award will not violate any provision of Kentucky's campaign finance laws. For purposes of this attestation, "knowingly" is defined as awareness or reasonable awareness of a violation's existence.
The completed affidavit must be notarized and submitted to the Commonwealth prior to contract award. The affidavit remains effective for one year from the date of execution, and the Commonwealth retains the right to request an updated affidavit at any time. The form requires completion of contractor information including printed name, title, signature, date, bidder or offeror name, address, and Kentucky vendor code if known. A notary public must verify the attestation, providing their signature, commission expiration date, and the state and county where the oath was administered.
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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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