2-Certification Addendum Acknowledgement Form.pdf
PDF 110 KB Posted
- Attached to
- Barricades Traffic Cones and Accessories
- Solicitation number
- RFB-26-127
- Issued by
- Yuma County, Arizona
About this file
This is a Certification & Addenda Acknowledgement Form issued by the City of Yuma's Procurement Division on November 6, 2024, for Request for Bid (RFB) RFB-26-127 regarding Barricades Traffic Cones and Accessories. The form serves as the official submission document through which respondents acknowledge receipt of all solicitation documents and any issued addenda posted on the City of Yuma's Bonfire Procurement Portal. Respondents are required to verify that all addenda have been reviewed prior to submission, as the City assumes no responsibility for failure to receive posted amendments. The form requires completion of respondent company information, including authorized representative contact details, company address, and offer date.
By signing this certification form, the respondent's authorized representative attests to four key commitments: non-discrimination against employees and applicants in accordance with Federal Executive Order 11246 and Arizona Revised Statutes Section 34-101 et seq.; confirmation that no gratuities, loans, discounts, or favors have been offered to any public servant in connection with the bid; authority to bind the company to the resulting contract; and receipt and consideration of all addenda. Respondents must upload the completed form to the Procurement Portal associated with the solicitation to ensure their bid is processed appropriately.
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Text version
Procurement Division
November 6, 2024
Certification & Addenda Acknowledgement Form
Solicitation addenda are posted on the City of Yuma’s Bonfire Procurement Portal identified as:
Ref #: _____________
Project: _______________________________________________________________________________
Any changes to the solicitation document will be in the form of an Addendum. It is the responsibility of the Responder to check the Yuma Procurement Portal for any addenda to the solicitation. The City will not be held responsible if a Responder fails to receive any addenda issued. Any City changes must be in writing.
Submission of Response: The undersigned representative offers and agrees to provide goods and/or services in compliance with all solicitation documents.
Offer Date: ________________________
Responder Company Name Contact Phone #
Address Printed Name
City, State, ZIP Title
Contact Email Address Signature of Person Authorized to Sign Offer
By signing above, the representative certifies:
1. The Responder company will not discriminate against any employee, or applicant for employment in violation of Federal Executive Order 11246 or A.R.S. 3101461 Et. Seq.
2. The Responder company has not given, offered to give, a loan, a gratuity, a special discount, a tip, or any favor, or service to a public servant in connection with the submitted bid.
3. The Representative signing this certification has the authority to bind the Responder to this contract.
4. The Representative’s signature confirms receipt and consideration of all information contained in any addenda.
Upload this document to the Procurement Portal for the associated solicitation.
| Ref 1: RFB-26-127 |
| Ref 2: Barricades Traffic Cones and Accessories |
| Responder Company Name: |
| Contact Phone: |
| Address: |
| Printed Name: |
| City State ZIP: |
| Title: |
| Contact Email Address: |
| Date1_af_date: |
File details come from the government source that posted it. Updated .