Attachment C Annual Affidavit and Other Affidavit(s).pdf
PDF 157 KB Posted
- Attached to
- NCR Paper for KY Correctional Industries
- Solicitation number
- RFB 758 2700000152 3
- Issued by
- Morgan County, Kentucky
About this file
This is a Required Affidavit for Bidders, Offerors, and Contractors form issued by the Commonwealth of Kentucky, applicable to the NCR Paper for KY Correctional Industries contract opportunity. The affidavit is mandated under Kentucky Revised Statutes (KRS) 45A.110 and 45A.115 and must be completed, notarized, and submitted by an authorized representative of any bidder or contractor seeking to be awarded or renew a contract with the Commonwealth. The affidavit remains effective for one year from the date of execution. All bidders must attest under penalty of perjury that the Contractor has not knowingly violated campaign finance laws of Kentucky and that contract award will not violate any provision of Kentucky's campaign finance laws. The Commonwealth retains the right to request an updated affidavit at any time during the contract period.
The form requires completion of standard attestation elements including the authorized representative's signature, printed name, title, and date, along with the bidder or offeror's name, address, and Commonwealth of Kentucky vendor code if available. The attestation must be notarized before a notary public, with the notary providing their signature, commission expiration date, and the state and county where the notarization occurs. The form serves as a compliance requirement for all bidders regardless of bid amount or contract value.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment B Bid Sheet.xlsx | XLSX spreadsheet | |
| Final_RFB_758_2700000152_1_SO_FORM.PDF | ||
| Attachment D Vendors' Question Form.xlsx | XLSX spreadsheet | |
| Final_RFB_758_2700000152_2_SO_FORM.PDF | ||
| Final_RFB_758_2700000152_3_SO_FORM.PDF | ||
| Attachment E Addendum 1.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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