Attachment B Annual Required Affidavit for Bidders Offerors and Contractors.pdf
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- Solicitation number
- RFP 126 2600000479 2
- Issued by
- Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors document issued by the Commonwealth of Kentucky in compliance with KRS 45A.110 and 45A.115. The affidavit is mandatory for any entity seeking to be awarded a contract or renew an existing contract with the state. An authorized representative of the contracting party must complete the attestation, obtain notarization, and submit the completed affidavit to the Commonwealth. The affidavit is valid for one year from the date of execution and certifies that the contractor has not knowingly violated Kentucky's campaign finance laws and that contract award will not violate any provision of campaign finance legislation. The term "knowingly" is defined as awareness or should-have-been awareness of a violation's existence.
The affidavit form requires the bidder or offeror to provide their legal name, complete address, and Commonwealth vendor code if available. The authorized representative must sign and print their name, provide their title, and include the execution date. A notary public must then subscribe and swear to the attestation before a notary in a specified Kentucky county, with the notary providing their name, commission expiration date, and county of commission. The Commonwealth reserves the right to request an updated affidavit at any time during the contract period. No pricing terms, set-asides, funding sources, or other financial considerations are addressed in this affidavit document, as it serves solely as a compliance certification for campaign finance law adherence.
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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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