Attachment A - Annual Required Affidavit for Bidders Offerors and Contractors.pdf
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- Attached to
- Child Support Genetic Testing
- Solicitation number
- RFP 040 2600000321 2
- Issued by
- Kentucky
About this file
This is an Annual Required Affidavit form mandated by the Commonwealth of Kentucky under KRS 45A.110 and 45A.115 for bidders, offerors, and contractors seeking to be awarded or renew contracts with the state. The affidavit must be completed by an authorized representative of the contracting party, notarized, and submitted to the Commonwealth to satisfy statutory requirements. The attestation confirms that the contractor has not knowingly violated Kentucky's campaign finance laws and that contract award will not violate any provision of such laws. The affidavit remains effective for one year from the date of execution. All bidders and offerors must provide complete information including their legal name, address, vendor code if known, and authorization for the Commonwealth to request updated affidavits at any time.
The affidavit requires notarization before a qualified notary public, with the notary providing their name, commission expiration date, state, and county of authority. The document applies to the Child Support Genetic Testing contract opportunity in Kentucky and serves as a compliance mechanism to ensure contractors maintain adherence to state campaign finance regulations. Failure to submit the required affidavit or submission of a false affidavit may result in contract ineligibility or disqualification.
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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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