00 45 19 Non Collusion Affidavit.pdf
PDF 145 KB Posted
- Attached to
- 2027 Sewer System Improvements Project
- Solicitation number
- Not on record
- Issued by
- Dauphin County, Harveys Lake Borough, Pennsylvania
About this file
This is a Non-Collusion Affidavit form required for submission by contractors bidding on Capital Region Water (CRW) projects in Pennsylvania. The affidavit serves as a sworn certification that bidders must complete and notarize as part of their bid submission for CRW procurements, including the 2027 Sewer System Improvements Project. The form requires the contractor's authorized representative to affirm that bid pricing has been developed independently without consultation, communication, or agreement with competing bidders, and that neither the bid price nor approximate pricing has been disclosed to other potential bidders prior to bid opening. Bidders must certify that no attempts have been made to induce competitors to refrain from bidding, submit noncompetitive bids, or engage in complementary bidding practices. The affidavit explicitly requires contractors to disclose any convictions or findings of liability within the preceding four years related to conspiracy or collusion in public contract bidding under state or federal law.
The completed affidavit must be sworn to and subscribed before a notary public and must include the contractor's name, company, position, notary signature, and commission expiration date. Misstatements in the affidavit are treated as fraudulent concealment of material facts from CRW, and the owner relies on these representations as material and important to the contract award decision. This document is a standard procurement compliance requirement demonstrating the contractor's commitment to fair and ethical bidding practices.
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Text version
00 45 19 Non-Collusion Affidavit
NON-COLLUSION AFFIDAVIT
STATE OF :
S.S.
COUNTY OF : CONTRACT NO.
I state that I am [Title] of [Contractor] and that I am authorized to make this affidavit on behalf of my firm, and its owners, directors, and officers. I am the person responsible in my firm for the price(s) and the amount of this bid.
I state that:
(1) The price(s) and amount of this bid have been arrived at independently and without consultation, communication or agreement with any other contractor, bidder or potential bidder.
(2) Neither the price(s) nor the amount of this bid, and neither the approximate price(s) nor approximate amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder, and they will not be disclosed before bid opening.
(3) No attempt has been made or will be made to induce any firm or person to refrain from bidding on this contract, or to submit a bid higher than this bid, or to submit any intentionally high or noncompetitive bid or other form of complementary bid.
(4) The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from, any firm or person to submit a complementary or other noncompetitive bid.
(5) _________________________________ (Contractor), its affiliates, subsidiaries, officers, directors and employees and have not, in the last four years, been convicted or found liable for any act prohibited by State or Federal law in any jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract, except as follows:
I state that (Contractor) understands and acknowledges that the above representations are material and important, and will be relied on by the ______________________ (Owner) in awarding the contract(s) for which this bid is submitted. I understand and my firm understands that any misstatement in this affidavit is and shall be treated as fraudulent concealment from the (Owner) of the true facts relating to the submission of bids for this contract.
00 45 19 Non-Collusion Affidavit
SWORN TO AND SUBSCRIBED BEFORE ME
THIS DAY OF Name and Company Position
Notary Public
Signature Date
(SEAL)
My Commission Expires:
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