2-Affidavit.pdf
PDF 163 KB Posted
- Attached to
- Watershed Improvement Preliminary Project Study State and local contract opportunity
- Solicitation number
- RFP-25-0092
- Issued by
- Johnson County, Kansas
About this file
This document is an affidavit form required by the City of Olathe, Kansas for contractors and vendors participating in city solicitations and contracts. The form serves as a sworn statement that must be completed, notarized, and submitted as part of the bidding or contracting process with the city. The affidavit requires disclosure of any financial interests that City of Olathe officers, agents, or employees may have in the contracting firm or any resulting contracts, and includes spaces for the contractor's information, authorized representative details, and notarization requirements.
The affidavit specifically addresses conflict of interest provisions by requiring contractors to declare whether any city personnel would benefit financially from the proposed contract or services. Additionally, the form includes an anti-collusion clause where contractors must affirm they have not participated in collusion or acts in restraint of trade related to city solicitations. The document requires the contractor's federal tax identification number, authorized representative signature, company contact information, and must be properly notarized to be valid for submission to the City of Olathe.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 1-RFP-25-0092 Preliminary Project Study.pdf |
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Text version
CITY OF OLATHE, KANSAS
AFFIDAVIT
STATE OF )
) SS.
COUNTY OF )
of the City of , (Name of Individual)
County of , State of , being duly sworn on her or his oath, states;
1. That I am the (Title) of (Firm Name), and have been authorized by said firm to make this affidavit on its behalf;
2. (Check the box the applies) No officer, agent or employee of the City of Olathe, Kansas is financially interested, directly or indirectly, in what firm is offering to sell to the City pursuant to any solicitation issued by the City of Olathe;
OR
The following officer(s), agent(s), or employee(s) of the City of Olathe would be financially interested in or receive a benefit from the profit or payments of any contract, job work, or service provided to the City of Olathe: (list all such officers, agents, or City employees on a separate sheet);
3. (Check the box that applies) If firm were awarded any contract, job work, or service for the City of Olathe, Kansas, no officer, agent or employee of the City would be financially interested in or receive any benefit from the profit or payments of such;
OR
The following officer(s), agent(s), or employee(s) of the City of Olathe would be financially interested in or receive a benefit from the profit or payments of any contract, job work, or service provided to the City of Olathe: (list all such officers, agents, or City employees on a separate sheet);
4. Firm has not participated in collusion or committed any act in restraint of trade, directly or indirectly, which bears upon anyone's response or lack of response any solicitation issued by the City of Olathe.
(Firm Name) Federal Tax ID #
By: (Signature) Subscribed and sworn before me this day of
(Printed Name) 20
(Title)
Mailing Address NOTARY PUBLIC in and for the County of
City, State, Zip Code State of
Phone Fax My commission expires:
Email SEAL
| CITY OF OLATHE, KANSAS |
| AFFIDAVIT |
| COUNTY OF ) |
| County of , State of , |
| OR |
| OR |
File details come from the government source that posted it. Updated .