3-Certification Addendum Acknowledgement Form.pdf
PDF 116 KB Posted
- Attached to
- Cleanup, Boarding and Securing Buildings
- Solicitation number
- RFB-26-109
- Issued by
- Yuma County, Arizona
About this file
This document is a Certification & Addenda Acknowledgement Form from the Procurement Division of the City of Yuma for a solicitation referenced as RFB-26-109, specifically for a "Cleanup, Boarding and Securing Buildings" project. The form is dated November 6, 2024, and serves as a formal acknowledgment document for potential responders to the solicitation, requiring companies to confirm their understanding of the bidding process and compliance with various legal and ethical standards.
The form requires responders to verify they will not discriminate in employment, have not offered inappropriate gratuities to public servants, and that the signing representative has the authority to bind their company to the contract. Responders must upload this completed document to the City of Yuma's Bonfire Procurement Portal and are responsible for checking the portal for any addenda to the solicitation. The document emphasizes that the City will not be held responsible if a responder fails to receive issued addenda, and all changes to the solicitation must be made in writing.
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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-26-109 |
| Ref 2: Cleanup, Boarding and Securing Buildings |
| 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 .