Attachment C - Annual Affidavit - RFB 758 2700000102.pdf
PDF 120 KB Posted
- Solicitation number
- RFB 758 2700000102 1
- Issued by
- Kentucky
About this file
This is an Annual Affidavit form required by the Commonwealth of Kentucky for bidders, offerors, and contractors seeking to be awarded or renew contracts under RFB 758 2700000102. The affidavit is effective for one year from the date of execution and must be completed by an authorized representative of the contracting party, notarized, and submitted to the Commonwealth prior to contract award or renewal. The form requires attestation 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 Kentucky's campaign finance laws.
The contractor's authorized representative must swear under penalty of perjury to the accuracy of the attestation. "Knowingly" is defined as the bidder or offeror being aware or should have been aware of the existence of a violation. The Commonwealth retains the right to request an updated affidavit at any time. The completed affidavit must include the bidder or offeror name, address, Commonwealth of Kentucky vendor code if known, the notary's signature and information, and the date of notarization.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment A - RFB 758 2700000102.pdf | ||
| ATTACHMENT B - BID SHEET - RFB 758 2700000102.docx | DOCX document | |
| Final_RFB_758_2700000102_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 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: _____________________
File details come from the government source that posted it. Updated .