1-NON-COLLUSION AFFIDAVIT.pdf
PDF 245 KB Posted
- Attached to
- Laboratory Testing Services Re-Bid
- Solicitation number
- 50-ITB-26
- Issued by
- Brevard County, Florida
About this file
This is a Non-Collusion Affidavit form required by the City of Palm Bay, Florida for the Laboratory Testing Services Re-Bid contract opportunity. The affidavit is executed by the prime bidder and must be notarized before submission. The document serves as a sworn statement confirming that the bidder's submission is genuine and independent, with no collusive agreements, price-fixing arrangements, or sham bidding practices involved in the proposal process.
The affidavit requires the bidder to certify that neither they nor their officers, partners, owners, agents, representatives, or employees have engaged in any collusion, conspiracy, or unlawful agreement with other bidders or interested parties to manipulate bid prices, overhead, profit margins, or other cost elements. The signatory must affirm that all quoted prices are fair, proper, and untainted by any collusive conduct. The form must be notarized in Florida, Brevard County, with the notary indicating whether acknowledgment was made through physical presence or online notarization, and includes standard notarial certification elements including the notary's signature, printed name, seal or serial number, and date of notarization.
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| File | Type | Posted |
|---|---|---|
| 7-50-ITB-26 Bid Form.xlsx | XLSX spreadsheet | |
| 3-REFERENCES.pdf | ||
| 10-50-ITB-26 Water Parameter Schedule.xls | XLS spreadsheet | |
| 12-50-ITB-26 Addendum 2.pdf | ||
| 2-DRUG FREE WORKPLACE.pdf | ||
| 8-50-ITB-26 Bid Form R.xlsx | XLSX spreadsheet | |
| 5-STANDARD TERMS CONDITIONS.pdf | ||
| 6-DRAFT AGREEMENT.docx | DOCX document | |
| 4-HUMAN TRAFFICKING AFFIDAVIT.pdf | ||
| 11-50-ITB-26 Bid Form R.xlsx | XLSX spreadsheet | |
| 9-50-ITB-26 Addendum 1.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)
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