1-Certification Addendum Acknowledgement Form.pdf
PDF 135 KB Posted
- Attached to
- Fire Hydrants and Accessories
- Solicitation number
- RFB-26-308
- Issued by
- Yuma County, Arizona
About this file
This is a Certification and Addendum Acknowledgement Form for the City of Yuma, Arizona, related to a Fire Hydrants and Accessories procurement. The document serves as a formal acknowledgement by bidders that they have received and reviewed any addenda issued to the original solicitation. Bidders are required to complete and return this form as part of their bid submission to confirm receipt of all addendum documents and modifications to the original contract opportunity. The form typically includes spaces for the bidder's company name, authorized representative signature, date of acknowledgement, and a checklist or listing of all addenda issued for the procurement.
The form functions as a compliance mechanism ensuring that all bidders have access to the same current information and modifications prior to submitting their proposals. Failure to properly complete and return the Certification and Addendum Acknowledgement Form may result in bid rejection or other non-responsive determinations. This document is a standard procurement requirement that protects the City of Yuma by creating documented evidence that bidders have acknowledged receipt of all relevant contract modifications and supplemental instructions before final bid submission.
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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-26-308 |
| Ref 2: Fire Hydrants and Accessories |
| Responder Company Name: |
| Contact Phone: |
| Address: |
| Printed Name: |
| City State ZIP: |
| Title: |
| Contact Email Address: |
| Date1_af_date: |
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