3-Certification Addendum Acknowledgement Form.pdf
PDF 110 KB Posted
- Solicitation number
- RFB-26-162
- Issued by
- Yuma County, Arizona
About this file
This is a Certification & Addenda Acknowledgement Form issued by the Procurement Division of the City of Yuma, Arizona, for Solicitation RFB-26-162 regarding Drone Light Show Services for America's 250th Anniversary Celebration. The form establishes the process for solicitation addenda, which are posted on the City of Yuma's Bonfire Procurement Portal, and places responsibility on responders to monitor the portal for any amendments to the solicitation documents. The City of Yuma will not assume liability for responders who fail to receive issued addenda. Responders must submit their offers in compliance with all solicitation documents and acknowledge receipt and consideration of all addenda information through this certification form.
By signing the acknowledgement form, responders certify four key commitments: non-discrimination against employees and applicants for employment in accordance with Federal Executive Order 11246 and Arizona Revised Statutes 3101461 et seq.; that no gratuities, loans, special discounts, tips, or favors have been given or offered to public servants in connection with the bid; that the authorized representative has binding authority; and that the signature confirms receipt and consideration of all addenda information. Responders are required to upload the completed and signed form to the Procurement Portal for the associated solicitation.
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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-26-162 |
| Ref 2: Drone Light Show Services for America’s 250th Anniversary Celebration |
| 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 .