13-J-8 Authorized Signatory Statement.pdf
PDF 81 KB Posted
- Attached to
- Colonial Avenue Sewer Separation
- Solicitation number
- 2000
- Issued by
- Alexandria City, Virginia
About this file
This is an Authorized Signatory Statement for the Colonial Avenue Sewer Separation project, a solicitation issued by the City of Virginia. The project involves installing 192 feet of 12-inch PVC pipe using horizontal boring techniques, replacing 351 feet of existing PVC pipe, installing and connecting to manholes, and reconnecting laterals. By signing this statement, the authorized representative certifies that they possess full authority to submit the response on behalf of their organization and to bind the respondent to all solicitation requirements, terms, and conditions.
The signatory affirms that the response is submitted independently without collusion with other bidders, that all information provided is accurate and complete, and that the respondent complies with applicable ethics in public contracting regulations and drug-free workplace requirements as mandated by Virginia law. The statement also confirms the respondent's understanding that any material misrepresentation may result in response rejection, termination of negotiations, or other remedies available to the City. The authorized signatory must provide their signature, printed name, title, the respondent's legal name, address, and contact information on the completed form.
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Text version
J-8
ITB 2000, Colonial Avenue
Authorized Signatory Statement
By signing below, the undersigned certifies and represents that:
1. Authority / Binding Offer: The undersigned is an officer, partner, member, manager, or duly authorized agent of the Respondent with full authority to submit this Response on behalf of the Respondent and to bind the Respondent to the representations made herein and to the requirements of this Solicitation.
2. Validity of Response: This Response constitutes a firm and valid submission for evaluation purposes and shall remain effective for the period stated in the Solicitation
Documents, or, if no period is stated, for a reasonable period as determined by the City.
3. Acknowledgment of Solicitation Requirements: The Respondent acknowledges that it has read, understands, and agrees to comply with all requirements of the Solicitation
Documents, including all instructions, specifications or scope, evaluation criteria, applicable terms and conditions, and all addenda issued by the City (as acknowledged by the Respondent).
4. No Collusion / Independent Submission: The Respondent certifies that this Response has been prepared and submitted independently and without collusion, consultation, communication, or agreement with any other respondent, bidder, or offeror regarding prices, qualifications, intent to submit, or response terms, except as expressly permitted by law. The Respondent understands that false certification may subject it to criminal and
Tony Esse Inserted Text civil penalties.
5. Ethics in Public Contracting: The Respondent certifies that it has not offered, given, or agreed to give any City employee or official any gratuity, kickback, or thing of value in connection with this Solicitation and will comply with all applicable ethics in public contracting requirements
6. Drug-Free Workplace (when applicable): Where required by Virginia law and/or the
Solicitation Documents, the Respondent certifies that it will provide and maintain a drug-free workplace during performance of any resulting contract and will include the required provisions in subcontracts.
7. Accuracy / Non-Misrepresentation: The Respondent certifies that all information submitted in its Response is true, complete, and accurate, and to the best of its knowledge and acknowledges that any material misrepresentation may result in rejection of the
Response, termination of negotiations, termination for default, and/or other remedies available to the City.
Authorized Signature: Date:
Printed Name: Title:___________________________________
Respondent Legal Name:______________________________
Address:_________________________________________________
Phone/Email: _________________________________________________________________
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