3-Certification Addendum Acknowledgement Form.pdf
PDF 129 KB Posted
- Attached to
- RFB-26-216 Traffic Control Services
- Solicitation number
- RFB-26-216
- 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-26-216 Traffic Control Services. The form serves as the official submission document whereby responders offer to provide traffic control services for various parades, community events, and other City projects in compliance with all solicitation documents. Responders are required to acknowledge receipt and consideration of all addenda posted on the City of Yuma's Bonfire Procurement Portal, as the City will not be responsible for responders who fail to receive issued addenda. The form requires responders to provide company name, contact information, address, authorized representative details, and the date of offer submission.
By signing the certification form, responders attest to four key commitments: non-discrimination in employment practices in accordance with Federal Executive Order 11246 and Arizona Revised Statutes 3101461 et seq.; that no gratuities, loans, discounts, tips, or favors have been offered to public servants in connection with the bid; that the signing representative has authority to bind the company to the contract; and that the signature confirms receipt and consideration of all addenda information. Responders must upload the completed and signed form to the Procurement Portal for the associated RFB-26-216 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: RFB-26-216 |
| Ref 2: Traffic Control Services |
| 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 .