1-Certification Addendum Acknowledgement Form.pdf
PDF 123 KB Posted
- Attached to
- Lubricants, Motor Oils and Greases
- Solicitation number
- RFB-26-251
- Issued by
- Yuma County, Arizona
About this file
This is a Certification & Addenda Acknowledgement Form issued by the City of Yuma's Procurement Division on November 6, 2024, for solicitation RF-26-251 regarding the procurement of Lubricants, Motor Oils and Greases. The solicitation requires delivery of bulk products in 55-gallon drums and cases of various oils, lubricants, and greases. Responders are required to monitor the City of Yuma's Bonfire Procurement Portal for any addenda issued to the solicitation documents, as the City will not be held responsible for any responder's failure to receive posted addenda. All changes to the solicitation will be communicated in written addendum form.
By executing this acknowledgement form, responder representatives certify their company's compliance with applicable federal and state anti-discrimination laws, confirm they have not offered improper consideration to any public servant in connection with the bid, authorize the signatory to bind the company to the contract, and acknowledge receipt and consideration of all addenda information. The completed form must be uploaded to the Procurement Portal for the associated solicitation. Responders must provide company name, contact information, authorized representative details, and contact email address on the form.
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Other files
| File | Type | Posted |
|---|---|---|
| 3-Special Terms Conditions and Additional Requirement.pdf | ||
| 4-Specifications.pdf | ||
| 2-Instructions, Standard Terms Conditions.pdf |
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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: RF-26-251 |
| Ref 2: Lubricants, Motor Oils and Greases |
| 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 .