ATTACHMENT B - Annual Affidavit - RFB 758 2600000247.pdf
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- Attached to
- KREC Errors & Omissions Insurance Policy
- Solicitation number
- RFB-758-2600000247-1
- Issued by
- Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky pursuant to Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. The affidavit is associated with a Kentucky Errors & Omissions Insurance Policy procurement (RFB 758 2600000247). The document requires an authorized representative of the bidding organization to complete an attestation confirming compliance with campaign finance laws, have the attestation notarized, and submit it to the Commonwealth. The affidavit is effective for one year from the date of execution and must be submitted to be awarded or renew a contract.
The attestation requires the bidder or offeror to swear under penalty of perjury that the organization has not knowingly violated Kentucky campaign finance laws and that contract award will not violate any provision of such laws. "Knowingly" is defined as awareness or reasonable awareness of a violation's existence. The affidavit form requires the authorized representative's signature, printed name, title, date, bidder or offeror name, address, vendor code, notarization by a notary public with commission expiration date, and state and county identification. The Commonwealth retains the right to request an updated affidavit at any time during the contract period.
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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 .