1-Certification Addendum Acknowledgement Form.pdf
PDF 110 KB Posted
- Attached to
- Greens Rye Grass Seed Varieties
- Solicitation number
- RFB-26-064
- Issued by
- Yuma County, Arizona
About this file
This document is a Certification & Addenda Acknowledgement Form from the Procurement Division of the City of Yuma, Arizona, for a solicitation (Reference Number RFB-26-064) related to Greens Rye Grass Seed Varieties. The form is designed for potential responders to acknowledge receipt of solicitation documents and addenda, with a submission deadline of November 6, 2024. Responders are required to review any changes to the solicitation through the City of Yuma's Bonfire Procurement Portal and confirm their understanding by completing and uploading this form.
The form includes several key certifications that a responder must agree to, including non-discrimination commitments, ethical procurement practices, and authorization to bind the responding company to the contract. Specifically, responders must certify they will not discriminate against employees, have not offered improper gratuities to public servants, and that the signing representative has the authority to commit the company. The document requires the responder to provide company contact information, and by signing, they confirm receipt and consideration of all addenda related to the solicitation for Greens Rye Grass Seed Varieties.
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Text version
Procurement Division
November 6, 2024
Certification & Addenda Acknowledgement Form
Solicitation addenda are posted on the City of Yuma’s Bonfire Procurement Portal identified as:
Ref #: _____________
Project: _______________________________________________________________________________
Any changes to the solicitation document will be in the form of an Addendum. It is the responsibility of the Responder to check the Yuma Procurement Portal for any addenda to the solicitation. The City will not be held responsible if a Responder fails to receive any addenda issued. Any City changes must be in writing.
Submission of Response: The undersigned representative offers and agrees to provide goods and/or services in compliance with all solicitation documents.
Offer Date: ________________________
Responder Company Name Contact Phone #
Address Printed Name
City, State, ZIP Title
Contact Email Address Signature of Person Authorized to Sign Offer
By signing above, the representative certifies:
1. The Responder company will not discriminate against any employee, or applicant for employment in violation of Federal Executive Order 11246 or A.R.S. 3101461 Et. Seq.
2. The Responder company has not given, offered to give, a loan, a gratuity, a special discount, a tip, or any favor, or service to a public servant in connection with the submitted bid.
3. The Representative signing this certification has the authority to bind the Responder to this contract.
4. The Representative’s signature confirms receipt and consideration of all information contained in any addenda.
Upload this document to the Procurement Portal for the associated solicitation.
| Ref 1: RFB-26-064 |
| Ref 2: Greens Rye Grass Seed Varities |
| Responder Company Name: |
| Contact Phone: |
| Address: |
| Printed Name: |
| City State ZIP: |
| Title: |
| Contact Email Address: |
| Date1_af_date: |
File details come from the government source that posted it. Updated .