1-004500 - Non-Collusion Affidavit.pdf
PDF 13 KB Posted
- Attached to
- Grit System Replacement
- Solicitation number
- Not on record
- Issued by
- Cumberland County, Pennsylvania
About this file
This is a Non-Collusion Affidavit form for the Lemoyne Municipal Authority's September 2026 Grit System Replacement project in Pennsylvania. The affidavit must be completed by the member, officer, or employee of the bidding firm responsible for making final pricing decisions. Bids are being accepted online through PennBid until 2:00 PM on October 6, 2026, with all project documents available at http://PennBid.bonfirehub.com. The successful bidder must substantially complete the project within 180 calendar days of receiving the Notice to Proceed. Bids must remain open for 60 days from the date of bid opening, or 120 days if award is delayed by required governmental approvals, bond sales, or grant awards. All bidders must bid on all items listed on the bid form, and the contract is subject to Pennsylvania Prevailing Wage Act conditions, OSHA requirements, Pennsylvania Act 229 of 2002, the Underground Utility Line Protection Law, the Pennsylvania Human Relations Act, and the Public Works Employment Verification Act.
A certified check or bid bond equal to 10% of the total bid amount, issued by a surety licensed in Pennsylvania, is required for bid submission. The successful bidder must furnish performance and payment bonds in the amount of 100% of the contract price. The affidavit requires bidders to certify that bid prices have been determined independently without consultation, communication, or agreement with other contractors or potential bidders, and that no complementary bids or bid-rigging activities have occurred. Bidders must also certify that their firm, affiliates, subsidiaries, officers, directors, and employees are not currently under investigation and have not been convicted or found liable in the past three years for any act involving conspiracy or collusion in public contract bidding. Failure to file a compliant affidavit will result in bid disqualification.
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Text version
Lemoyne Municipal Authority September 2026 Grit System Replacement
NON-COLLUSION AFFIDAVIT 004500-1
RETTEW Project No.: 112692012 All Contracts
NON-COLLUSION AFFIDAVIT
State of :
: SS
County of :
I state that I am of , and that I am authorized to make (Title) (Name of My Firm) 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. , its affiliates, subsidiaries, officers, directors and employees are not (Name of My Firm) currently under investigation by any governmental agency and have not in the last 3 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 understands and acknowledges that the above representations (Name of My Firm) are material and important, and will be relied on by in awarding the (Name of Public Entity) contract(s) for which this bid is submitted. I understand and my firm understands that any misstatement of this affidavit is and shall be treated as fraudulent concealment from of the true facts relating to submission of bids for this contract.
(Name of Public Entity)
(Name and Company Position)
SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF , 20 .
Notary Public My Commission Expires: ________________________
* Involvement in this activity does not prohibit the from accepting this bid or (Name of Public Entity) awarding a contract; but this may be a ground for determining whether the should (Name of Public Entity) decide to award a contract based on a lack of responsibility.
Lemoyne Municipal Authority September 2026 Grit System Replacement
NON-COLLUSION AFFIDAVIT 004500-2
RETTEW Project No.: 112692012 All Contracts
INSTRUCTIONS FOR NON-COLLUSION AFFIDAVIT
1. This Non-Collusion Affidavit is material to any contract awarded pursuant to this Bid.
According to the Pennsylvania Antibid-Rigging Act, 73 P.S. § 1611 et seq, governmental agencies may require Non-Collusion Affidavits to be submitted together with bids.
2. This Non-Collusion Affidavit must be executed by the member, officer or employee of the Bidder who makes the final decision on prices and the amount quoted in the Bid.
3. Bid rigging and other efforts to restrain competition, and making of false sworn statements in connection with the submission of Bids are unlawful and may be subject to criminal prosecution. The person who signs the Affidavit should examine it carefully before signing and assure themselves that each statement is true and accurate, making diligent inquiry, as necessary, of all other persons employed by or associated with the Bidder with responsibilities for the preparation, approval or submission of the Bid.
4. In the case of a Bid submitted by a joint venture, each party to the venture must be identified in the Bid documents, and an Affidavit must be submitted separately on behalf of each party.
5. The term "Complementary Bid" as used in the Affidavit has the meaning commonly associated with that term in the bidding process, and includes the knowing submission of bids higher than the bid of another firm, any intentionally high or noncompetitive bid, and any other form of bid submitted for the purpose of giving a false appearance of competition.
6. Failure to file an Affidavit in compliance with these instructions will result in disqualification of the Bid.
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