Attachment C Annual Affidavit and Other Affidavit(s).pdf
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- Solicitation number
- RFP 758 2600000435 1
- Issued by
- Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky in accordance with KRS 45A.110 and 45A.115. The affidavit applies to the Kentucky Cigarette Tax Stamps, Fulfillment and Distribution contract opportunity. An authorized representative of any bidding entity must complete, notarize, and submit this attestation to be eligible for contract award or renewal. The affidavit is effective for one year from the date of execution and may be requested in updated form at any time during the contract period.
The attestation requires the bidder's authorized representative to swear 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 provisions of those laws. For this purpose, "knowingly" is defined as awareness or constructive awareness of a violation's existence. The affidavit form requires completion of bidder or offeror name, address, Commonwealth of Kentucky vendor code if known, notarization details, and the representative's signature, printed name, title, and date. This mandatory compliance document serves as a prerequisite for participation in the contract solicitation process.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment D - Vendors' Question Form.xlsx | XLSX spreadsheet | |
| Attachment B - Cost Proposal Form.docx | DOCX document | |
| Final_RFP_758_2600000435_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 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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