18._CCHCS-MC-379-_Non-Collusion_Dec.pdf
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- Attached to
- On-Site Dialysis Request for Proposal SD23-00097
- Solicitation number
- 0000032853
About this file
This document is a Non-Collusion Declaration related to a state contract opportunity, Proposal Number SD23-00097 CCHCS-MC-379. The declaration affirms that the bid submitted is genuine and not collusive or sham, and that the Bidder has not directly or indirectly engaged in any collusive or conspiratorial activities with other Bidders to fix prices or secure an unfair advantage. The declaration also states that no owner, partner, member, director, officer, chief financial officer, manager, or employee of the Bidder shall be affiliated with any other Bidder to this Request for Proposal.
The document outlines the legal requirements and implications related to collusion and bid rigging, and requires the Bidder to declare under penalty of perjury that the information provided is true and correct. The declaration must be signed and dated by an authorized representative of the Bidder.
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Text version
Proposal Number: SD23-00097
CCHCS-MC-379 – Non-Collusion Declaration Rev. 09/13/2017
NON-COLLUSION DECLARATION
The undersigned declares:
1. I am the (Title) of (Name of Bidder), the party making the foregoing bid.
2. The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The Bidder has not directly or indirectly induced or solicited any other Bidder to put in a false or sham bid. The Bidder has not directly or indirectly colluded, conspired, connived, or agreed with any Bidder or anyone else to put in a sham bid, or to refrain from bidding. The Bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the Bidder or any other Bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other Bidder. All statements contained in the bid are true. The Bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
3. No owner, partner, member, director, officer, chief financial officer, manager, or employee of Bidder shall be an owner, partner, member, director, officer, chief financial officer, manager, or employee of any other Bidder to this Request for Proposal.
4. If the Bidder is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, I hereby represent that I have full power to execute, and do execute, this declaration on behalf of the Bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on (Date), at (City/State).
Signature
Printed Name
Attachment 18
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