11-09-Attachment-2 Non-collusion-Affidavit.pdf
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- Solicitation number
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- Bucks County, Pennsylvania
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This is a Non-Collusion Affidavit form required by the County of Bucks, Pennsylvania for bid submission under Specification #38-09/26. The affidavit serves as a material requirement for any contract or purchase order awarded through this bidding process, as authorized under Section 4507 of Pennsylvania's Act 57 of May 15, 1998 (62 Pa. C.S. § 4507). Bidders must execute the affidavit and certify that bid prices have been developed independently without consultation, communication, or agreement with other contractors or potential bidders. The form requires submission of the legal vendor name, authorized representative information, and signature with date prior to bid opening.
The affidavit obligates bidders to certify that they have not disclosed bid pricing to other vendors, have not attempted to induce competitors to refrain from bidding or submit noncompetitive bids, and are submitting bids in good faith without collusive agreements. Vendors must also certify that they and their affiliates, subsidiaries, officers, directors, and employees have not been convicted or found liable in the past four years for any acts involving conspiracy or collusion with respect to public contracts, and are not currently under suspension or investigation by any governmental entity. Any vendor unable to make these certifications must provide written explanation with their bid submission.
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NON-COLLUSION AFFIDAVIT
This Non-Collusion Affidavit is material to any contract/purchase order awarded pursuant to this bid. According to Section 4507 of Act 57 of May 15, 1998, 62 Pa. C.S,. ss 4507, governmental agencies may require Non-Collusion Affidavits to be submitted with any bids. By submittal of a bid for spec no _________ and execution of this affidavit, the following statements are acknowledged:
• The price(s) and amount of bid have been arrived at independently and without consultation, communication or agreement with any other Contractor, potential Contractor or bidder.
• Neither the price(s), amount of this bid nor the approximate price(s) or amount of bid, have been disclosed to any other company or person who may be a Vendor or potential Vendor, nor will they be disclosed prior to this bid opening.
• No attempt has been made, or will be made, to induce any company or person to refrain from bidding on this contract or submit a proposal higher than this bid, or to submit any intentionally high or noncompetitive bid or other form of complementary bid.
• This bid is made in good faith and not pursuant to any agreement or discussion with, or inducement from any company or person to submit a complementary or other noncompetitive bid.
• To my best knowledge, the Vendor, its affiliates, subsidiaries, officers, directors and employees are not currently under investigation by any governmental agency and have not in the last four years been convicted or found liable for any act prohibited by State or Federal law in any jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract.
• The Vendor is not currently under suspension or review by the commonwealth, or any other Federal, State or Local Governmental entity. If certification cannot be made, a written explanation to support the inability of providing such shall be submitted with this bid.
Legal Name of Vendor: _______________________________________________________
Authorized Representative Name:________________________________________________
Authorized Representative Title:_________________________________________________
Signature: ___________________________________________________________________
Date: _______________________________________
NON-COLLUSION AFFIDAVIT
| bid for spec no: 38-09/26 |
| Legal Name of Vendor: |
| Authorized Representative Name: |
| Authorized Representative Title: |
| Date: |
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