3-Certification Addendum Acknowledgement Form.pdf
PDF 123 KB Posted
- Attached to
- RFQ-26-226 Partnership Development & Implementation Management Services for Yuma Innovation District
- Solicitation number
- RFQ-26-226 Partnership Dev & Implementation Mgmt Svcs for Yuma Innovation District
- 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 RFQ-26-226 Partnership Development & Implementation Management Services for Yuma Innovation District. The form serves as the official acknowledgment that responders have received and reviewed all solicitation documents and any addenda posted on the City of Yuma's Bonfire Procurement Portal. Responders are required to complete and submit this form as part of their response package, confirming receipt of all addenda and understanding that the City is not responsible for failures to retrieve posted addenda. The form requires the responder to provide company name, contact information, address, authorized representative details, offer date, and the signature of a person with authority to bind the organization to the contract.
By signing this form, responders certify compliance with Federal Executive Order 11246 and Arizona Revised Statutes 3101461 regarding non-discrimination in employment; confirm they have not offered any gratuities, loans, discounts, or favors to public servants in connection with the bid; attest that the signatory has authority to bind the company; and acknowledge receipt and consideration of all addenda and solicitation documents. The form must be uploaded to the Procurement Portal for the associated solicitation and serves as a binding acknowledgment of the responder's commitment to provide goods and services in compliance with all terms and conditions of the solicitation.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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: RFQ-26-226 |
| Ref 2: Partnership Development & Implementation Management Services for Yuma Innovation District |
| 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 .