Attachment B - Annual Affidavit and Other Affidavits - Aug 2019.pdf

This document is an Affidavit form used by state and local agencies for annual certification and compliance purposes. The affidavit serves as a standardized attestation document that vendors, contractors, or entity representatives must complete and submit to demonstrate compliance with various regulatory and statutory requirements. The form requires signatories to affirm under oath that information provided is accurate and complete, and it establishes the legal responsibility of the affiant for the truthfulness of statements made. The document includes sections for identifying the affiant, their role, the entity they represent, and the specific period or matter to which the affidavit applies. The form requires notarization or official witness verification to validate the sworn statement, ensuring the authenticity and legal enforceability of the affirmation.

The affidavit form establishes accountability mechanisms for government contracting by requiring authorized representatives to personally certify compliance with applicable laws, regulations, and contract terms. This documentation requirement serves to protect state and local agencies by creating a legal record of contractor representations and enabling enforcement actions should any false statements be discovered. The affidavit may address various compliance areas such as business licensing, insurance coverage, non-discrimination practices, conflict of interest disclosures, or adherence to specific statutory requirements governing contractor eligibility. By requiring annual reaffirmation, agencies maintain current compliance documentation throughout the contract term and can address any changes in contractor status or circumstances that may affect their continued eligibility or performance obligations.