Attachment B - Annual Affidavit - RFB 758 2600000084.pdf
PDF 120 KB Posted
- Attached to
- Two (2) Draeger X-sites Meters - ERT
- Solicitation number
- RFB 758 2600000084 1
- Issued by
- Elliott County, 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 KRS 45A.115. The affidavit is effective for one year from the date of execution and applies to RFB 758 2600000084. As a mandatory requirement for contract award or contract renewal, an authorized representative of the bidding entity must complete the attestation, obtain notarization, and submit the executed document to the Commonwealth. The affidavit serves as a compliance verification mechanism requiring bidders to affirm under penalty of perjury that the contracting party has not knowingly violated Kentucky's campaign finance laws and that contract award will not violate any provision of those laws.
The attestation defines "knowingly" to mean that the bidder or offeror is aware or should have been aware of any violation's existence. The document requires completion of bidder or offeror identifying information including name, address, and Commonwealth of Kentucky vendor code if known. Notarization must be completed before a notary public with recorded commission expiration date, state, and county information. The Commonwealth retains the right to request an updated affidavit at any time during the contract period, and bidders should be aware that submission of false information under this affidavit constitutes perjury with associated legal consequences.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment A - RFB 758 2600000084-1 - 09-23-2025.pdf | ||
| Final_RFB_758_2600000084_1_SO_FORM.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 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: _____________________
File details come from the government source that posted it. Updated .