Attachment B Annual Affidavit and Other Affidavit(s).pdf
PDF 157 KB Posted
- Attached to
- Lab Coat and Hand Towel Rental
- Solicitation number
- RFB 758 2600000542 1
- Issued by
- Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors form issued by the Commonwealth of Kentucky in accordance with KRS 45A.110 and 45A.115, applicable to all bidders and contractors seeking to be awarded or renew contracts with the state of Kentucky, including the Lab Coat and Hand Towel Rental opportunity. The affidavit must be completed and notarized by an authorized representative of the contracting party prior to contract award. The form requires submission of bidder or offeror information including company name, address, and vendor code, along with an attestation that the contractor has not knowingly violated Kentucky campaign finance laws and that contract award will not violate any provision of the state's campaign finance laws. The affidavit is effective for one year from the date of execution, though the Commonwealth retains the right to request an updated affidavit at any time during the contract term.
No pricing, set-asides, incumbent information, or funding details are specified in this affidavit document. The form serves solely as a compliance and certification mechanism to ensure that all contractors meet Kentucky's campaign finance law requirements before contract execution. "Knowingly" is defined as the bidder or offeror being aware or should have been aware of the existence of a violation. The completed affidavit must be notarized and include the notary's commission expiration date before submission to the Commonwealth.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFB_758_2600000542_1_SO_FORM.PDF | ||
| Attachment C Vendors' Question Form.xlsx | XLSX spreadsheet |
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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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