ATTACHMENT B - Annual Required Affidavit for Bidders Offerors and Contractors.pdf
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- Attached to
- KDF Hoop Barn at Pennyrile State Forest
- Solicitation number
- RFQ 128 2600000009 1
- Issued by
- Harrison County, Kentucky
About this file
This is an affidavit form required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking to be awarded or renew state contracts. The form, effective for one year from the date of execution, mandates compliance with Kentucky Revised Statutes (KRS) 45A.110 and 45A.115 regarding campaign finance laws. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the completed affidavit to the Commonwealth. The affidavit serves as a prerequisite for contract award or renewal and may be requested for updates at any time during the contract period.
The attestation requires the bidder or offeror to swear and affirm under penalty of perjury that the contractor has not knowingly violated Kentucky's campaign finance laws and that the contract award will not violate any provision of these laws. For purposes of the attestation, "knowingly" is defined as awareness or should-have-been awareness of a violation's existence. The form requires the signature of a duly authorized representative, printed name, title, and date, along with notarization by a notary public including the notary's signature, commission expiration date, and the county and state where the affidavit is sworn. The form also collects the bidder or offeror's name, complete address, and Commonwealth of Kentucky vendor code if available.
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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: _____________________ 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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