1-NON-COLLUSION AFFIDAVIT.pdf
PDF 245 KB Posted
- Attached to
- Lockbox Services
- Solicitation number
- 42-ITB-26
- Issued by
- Brevard County, Florida
About this file
This document is a Non-Collusion Affidavit form for the City of Palm Bay, Florida, designed for prime bidders responding to the City's Invitation to Bid for Lockbox Services. The affidavit requires the bidder's authorized representative to certify under oath that the submitted bid is genuine and prepared without collusion or conspiracy with other bidders. The affiant must confirm that no parties associated with the bidder, including officers, partners, owners, agents, representatives, employees, or parties in interest, have engaged in any unlawful agreement to submit sham bids, refrain from bidding, fix pricing, or secure unfair advantages against the City or other interested parties. The form is notarized before a notary public in Florida, Brevard County, with space for the notary to indicate whether acknowledgment occurred through physical presence or online notarization.
This form is a standard compliance document required as part of the bidding process for the lockbox services contract, which involves processing approximately 58,000 utility, sanitation, and stormwater billing accounts monthly across five billing cycles, plus approximately 23,500 stormwater-only accounts billed annually for the City's Customer Care Division. The affidavit enforces anti-collusion regulations and must be completed, signed, and notarized by the prime bidder before bid submission to ensure fair competition and procurement integrity.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 8-42-ITB-26 Lockbox Services Bid Form.xlsx | XLSX spreadsheet | |
| 5-STANDARD TERMS CONDITIONS.pdf | ||
| 3-REFERENCES.pdf | ||
| 7-42-ITB-26 Exhibit 1.pdf | ||
| 9-Lockbox Insurance.pdf | ||
| 6-DRAFT AGREEMENT.docx | DOCX document | |
| 4-HUMAN TRAFFICKING AFFIDAVIT.pdf | ||
| 2-DRUG FREE WORKPLACE.pdf |
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Text version
SECTION 00301
NON-COLLUSION AFFIDAVIT OF PRIME BIDDER
STATE OF
COUNTY OF
, being duly sworn, deposes and says that:
(1) He/she is of , the (Title) (Firm/Company) Bidder that has submitted the attached Bid.
(2) He/she is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid.
(3) Such Bid is genuine and is not a collusive or sham Bid.
(4) Neither the said Bidder nor any of its officers, partners, owners, agent representatives, employees or parties in interest including this affiant, has in any way, colluded, conspired, or agreed, directly or indirectly, with any other Bidder, firm or person, to submit a collusive or sham Bid in connection with the Agreement for which the attached Bid has been submitted or to refrain from proposing in connection with such Agreement, or has in any manner, directly or indirectly, sought by Agreement or collusion or communication or conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix any overhead, profit or cost element of the Bid price or the Bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance or unlawful Agreement any advantage against the City of Palm Bay, Florida, or any person interested in the proposed Agreement.
(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, or unlawful Agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties of interest, including affiant.
(Signed)
(Title)
STATE OF FLORIDA
COUNTY OF BREVARD
The foregoing instrument was acknowledged before me, by means of ___ physical presence or ___ online notarization, this _______ day of _______________, _______ (year) by
_____________________________, who is personally known to me or who has produced
_______________________________ as identification and who did (did not) take an oath.
(Signature of Notary Public)
(Name of Notary – Typed, printed or stamped)
(Notary Seal / Serial Number)
(Date)
File details come from the government source that posted it. Updated .