26CRY008_-_Non_Collusion_Declaration.pdf
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- Solicitation number
- 0000039790
- Issued by
- Colusa County, Contra Costa County, Lake County, Marin County, Napa County, Solano County, Sonoma County, Yolo County, Colusa City, Contra Costa Centre CDP, Auburn Lake Trails CDP, South Lake Tahoe City, Shaver Lake CDP, Blue Lake City, China Lake Acres CDP, Lake Isabella CDP, Lake of the Woods CDP, Lakeside CDP, Hidden Valley Lake CDP, Lakeport City, Lower Lake CDP, North Lakeport CDP, Upper Lake CDP, Elizabeth Lake CDP, Lake Hughes CDP, Lake Los Angeles CDP, Lakewood City, Marina Del Rey CDP, San Marino City, Bass Lake CDP, Yosemite Lakes CDP, Lucas Valley-Marinwood CDP, Marin City CDP, Lake Don Pedro CDP, Lake City CDP, Crowley Lake CDP, June Lake CDP, Mammoth Lakes Town, Twin Lakes CDP, Virginia Lakes CDP, Marina City, Napa City, Lake of the Pines CDP, Lake Wildwood CDP, Lake Forest City, Bucks Lake CDP, Lake Almanor Country Club CDP, Lake Almanor Peninsula CDP, Lake Almanor West CDP, Lake Davis CDP, Canyon Lake City, Lake Elsinore City, Lakeland Village CDP, Lake Mathews CDP, Lake Riverside CDP, Lakeview CDP, Big Bear Lake City, Lake Arrowhead CDP, Silver Lakes CDP, Spring Valley Lake CDP, Lake San Marcos CDP, Lake Nacimiento CDP, Emerald Lake Hills CDP, Lakehead CDP, Shasta Lake City, Lake Shastina CDP, Sonoma City, Sonoma State University CDP, Lake California CDP, Phoenix Lake CDP, Pine Mountain Lake CDP, Lake Sherwood CDP, Yolo CDP, Plumas Lake CDP, California
About this file
This is a Non-Collusion Declaration form required by the California Department of Veterans Affairs for solicitation 26CRY008 regarding Temporary Relief Speech Pathology Services at the Veterans Home of California at Yountville. The declaration must be executed by an authorized representative of the bidding entity and submitted as part of the bid response. The form requires the bidder to certify under penalty of perjury that the bid is genuine, not collusive or sham, and that no coordination or price-fixing has occurred with other bidders or parties.
The declaration mandates that bidders confirm they have not induced other bidders to submit false bids, have not colluded to fix prices or cost elements, and have not divulged bid information to unauthorized parties. Authorized signatories of corporations, partnerships, joint ventures, limited liability companies, or other entities must represent that they possess full power to execute the declaration on behalf of the bidding organization. The completed form must be signed, dated, and executed in California before submission with the bid package.
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State of California Solicitation Number: 26CRY008 Department of Veterans Affairs
NON-COLLUSION DECLARATION
The undersigned declares:
I am the of (Bidder), the party making the foregoing
(Title) (Name of Bidder) bid. 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.
Any person executing this declaration on behalf of the Bidder, if the Bidder is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does 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 , at , California.
(Date) (City)
Company Representative Signature
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