Attachment B Annual Required Affidavit for Bidders Offerors and Contractors.pdf
PDF 253 KB Posted
- Solicitation number
- RFP 126 2600000479 1
- Issued by
- Kentucky
About this file
This is a Required Affidavit form for Bidders, Offerors, and Contractors established under Kentucky Revised Statutes 45A.110 and 45A.115, applicable to state contracts in Kentucky. The affidavit must be completed by an authorized representative of any bidder, offeror, or contractor seeking to be awarded a contract or contract renewal with the Commonwealth of Kentucky. The attestation requires the authorized representative to swear under penalty of perjury that the contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that the contract award will not violate any provision of Kentucky's campaign finance laws. The affidavit is effective for one year from the date of execution and must be notarized by a qualified notary public before submission to the Commonwealth.
The form requires completion of standard contractor identification information including the bidder or offeror name, address, and vendor code if known. The authorized representative must provide their signature, printed name, title, and the execution date, followed by notarization including the notary's signature, name, commission expiration date, state and county of notarization, and the date sworn. The Commonwealth of Kentucky retains the right to request an updated affidavit at any time during the contract period. This affidavit requirement applies to all contract opportunities with the state and serves as a prerequisite to contract award and renewal.
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Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT-A_TechnicalResponseForm.pdf | ||
| Final_RFP_126_2600000479_1_SO_FORM.PDF | ||
| ATTACHMENT-C_MOVEit_TransferInstructions.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: _____________________ 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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| Vendor Code: |
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| Notary Name: |
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