2-3 Acceptance and Disclosures Form.pdf
PDF 16 KB Posted
- Attached to
- Solid Waste Disposal Services
- Solicitation number
- ITB-2026-34RB
- Issued by
- Doña Ana County, New Mexico
About this file
This is an Acceptance and Disclosures Form for Gallup McKinley County Schools (GMCS) in New Mexico related to a Solid Waste Disposal Services contract. The form establishes the terms under which vendors must submit bids or proposals in response to the solicitation. Vendors are required to certify that they have read and understand all general and special conditions, bid documents, specifications, scope of work, and contract terms, and that they agree to comply with these requirements. Additionally, vendors must acknowledge that their bid/proposal will remain firm for up to 60 days to allow the District adequate time to evaluate submissions.
The form requires vendors to make several critical certifications regarding conflict of interest, non-collusion, and debarment status. Vendors must declare that no GMCS employee, board member, or close relative has a direct or indirect financial interest in their company or the proposed transaction, and that they are not employing or negotiating to employ any GMCS personnel. Vendors must certify under penalty of perjury that their response is bona fide and made without collusion or fraud. Furthermore, vendors must confirm that they are not suspended, debarred, or ineligible from contracting with the Federal Government, any State agency, or any local public body, and agree to provide immediate notice to the GMCS Procurement Department should such status change. The authorized signatory must certify they have read and understand all requirements and have the authority to bind the Vendor to compliance with these terms.
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Text version
ACCEPTANCE AND DISCLOSURES FORM
As utilized herein, the term "Vendor" shall mean that entity submitting a bid/proposal to Gallup McKinley County
Schools (GMCS) in response to the attached solicitation.
ACCEPTANCE OF CONDITIONS GOVERNING PROCUREMENT
The Vender certifies that they have read and understand all general and special conditions and bid/proposal documents, and that they accept these conditions and submit the attached response in full compliance with these conditions, specifications, applicable scope of work, and contract. The Vendor agrees that the bid/proposal will remain firm for the period of up to 60 days in order to allow the District adequate time to evaluate the qualifications submitted.
CONFLICT OF INTEREST
The authorized Person, Firm and/or Corporation states that to the best of his/her belief and knowledge: No employee or board member of GMCS (or close relative), with the exception of the person(s) identified below, has a direct or indirect financial interest in the Vendor or in the proposed transaction. Vendor neither employs, nor is negotiating to employ any GMCS employee, board member or close relative, with the exception of the person(s) identified below. Vendor did not participate, directly or indirectly, in the preparation of specifications upon which the quote or offer is made.
CERTIFICATION OF NON-COLLUSION
Vendor certifies under penalty of perjury that its response to this procurement solicitation is in all respects bona fide, fair, and made without collusion or fraud with any person, joint venture, partnership, corporation or other business or legal entity.
Initials of Authorized Representative _________
DEBARMENT/SUSPENSION STATUS
The Vendor certifies that it is not suspended, debarred or ineligible from entering into contracts with the Federal Government, or any State agency or local public body, or in receipt of a notice or proposed debarment from any Federal or State agency or local public body. The vendor agrees to provide immediate notice to the GMCS Procurement Department in the event of being suspended, debarred or declared ineligible by any department or agency of the Federal government, or any agency of local public body of the State of New Mexico, or upon receipt of a notice of proposed debarment that is received after the submission of the quote or offer but prior to the award of the purchase order or contract.
CERTIFICATION
The undersigned hereby certifies that he/she has read the above ACCEPTANCE, CONFLICT OF INTEREST, NONCOLLUSION and DEBARMENT/SUSPENSION status requirements and that he/she understands and will comply with these requirements. The undersigned further certifies that they have the authority to sign, bind, and certify compliance for the Vendor named and that the information contained in this document is true and accurate to the best of their knowledge.
Signature Date
Name of Signatory Title
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