Attachment B Annual Affidavit and Other Affidavit(s).pdf
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- Attached to
- Dual Channel Canister and Carbonyl Sampler
- Solicitation number
- RFB 758 2600000427 1
- Issued by
- Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors document issued by the Commonwealth of Kentucky pursuant to KRS 45A.110 and 45A.115. The affidavit is required for any bidder, offeror, or contractor seeking to be awarded a contract or contract renewal with the state of Kentucky. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the completed affidavit to the Commonwealth. The affidavit is effective for one year from the date of execution. The document specifies that bidders and offerors must attest under penalty of perjury that they have 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.
The attestation requires the authorized representative to provide the bidder or offeror name, address, and Commonwealth of Kentucky Vendor Code if known. The document defines "knowingly" as meaning the bidder or offeror is aware or should have been aware of the existence of a violation. The Commonwealth reserves the right to request an updated affidavit at any time. The completed affidavit must include the signature, printed name, title, and date of the authorized representative, along with notarization information including the notary's name, commission expiration date, state, and county where the affidavit was sworn and subscribed.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_758_2600000427_1_SO_FORM.PDF | ||
| Attachment A RFB 758 2600000427.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 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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