2-04 - Non Collusion Affidavit.pdf

PDF 32 KB Posted

Attached to
457(b) Deferred Compensation Plan, Recordkeeping and Administration
Solicitation number
RFP 26-19659-KM
Issued by
Henderson County, Texas

About this file

This is a Non-Collusion Affidavit form required by Lubbock County, Texas for submission with bid proposals. The affidavit serves as a sworn statement in which the bidding firm certifies that its submission represents a genuine, independent bid made in good faith without collusion, sham bidding, or anti-competitive conduct. The form requires completion and signature by an authorized representative of the firm, followed by notarization before a notary public. The document must be included with all bid submissions as a mandatory component of the proposal package for the 457(b) Deferred Compensation Plan recordkeeping and administration services contract.

The affidavit explicitly prohibits bidders from having directly induced or solicited competing firms to submit sham bids, solicited other entities to refrain from submitting qualifications, or sought unfair advantage over competing firms through collusive practices. Completion of this form is non-negotiable and failure to include it with the submission may result in bid rejection. The form provides blank spaces for the firm name, authorized signatory name, signature, title, and notarization details including the date the oath was administered and the notary public's expiration date.

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Text version

NON-COLLUSION AFFIDAVIT

STATE OF TEXAS

LUBBOCK COUNTY

_________________________________________________ being first duly sworn, on his/her oath, says that the bid above submitted is a genuine and not a sham or collusive bid, or made in the interest or on behalf of any person not therein named; and s/he further says that the said respondent has not directly induced or solicited any firm on the above work or supplies to put in a sham , or any other person or corporation to refrain from a statement of qualifications; and that said firm has not in any manner sought by collusion to secure to self an advantage over any other firm or firms.

Firm

Name

Signature

Title

Subscribed and sworn to before me this ______________ day of ___________ 20__

Notary Public

My Commission Expires: _______________________________________________

NOTE: THIS FORM MUST BE COMPLETED AND INCLUDED IN WITH THE SUBMISSION

File details come from the government source that posted it. Updated .