3-Doc 00 45 19 - NON-COLLUSION AFFIDAVIT.pdf
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- Attached to
- 2500999 - Canterbury Storm Sewer Replacement State and local contract opportunity
- Solicitation number
- Not on record
- Issued by
- Montgomery County, Mount Aetna CDP, Pennsylvania
About this file
This is a Non-Collusion Affidavit document required by Montgomery Township, Pennsylvania for CONTRACT 2025-00999 - Canterbury Storm Sewer Replacement. The affidavit must be completed and submitted by the contractor as part of the bidding process. The project involves the removal and replacement of approximately 1,800 feet of corrugated metal pipe (CMP) ranging from 12 inches through 57 inches x 38 inches on Canterbury Lane and Devonshire Drive, along with construction of new circular HDPE pipe and elliptical RCP storm sewer, replacement of three precast concrete storm sewer structures, and restoration of concrete curb, sidewalk, driveway apron, and asphalt roadway. Sealed bids must be submitted electronically via the PennBid Program by 10:00 A.M. on September 1, 2026, at which time bids will be publicly opened and read aloud at the Township offices located at 1001 Stump Road, Montgomeryville, PA 18936. No pre-bid meeting will be held for this project.
The affidavit requires the authorized representative of the bidding contractor to swear under oath that the bidder has not engaged in collusion, conspiracy, or any action restraining free competitive bidding; that all statements in the proposal are true and correct; and that the undersigned has not been convicted or found liable within the past three years for any act involving conspiracy or collusion with respect to bidding on public contracts. The contractor must also warrant that no person or selling agency has been employed or retained to solicit or secure the contract on a commission, percentage, brokerage, or contingent fee basis, except for bona fide employees or established commercial or selling agencies. The affidavit must be notarized and subscribed before a Notary Public. Bid security of not less than 10 percent of the bid amount must accompany each bid, along with an Agreement of Surety certifying that required Performance and Payment Bonds will be provided. This project is subject to Pennsylvania's Prevailing Wage Act (Act 422) and Public Works Employment Verification Act (Act 127).
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Text version
NON-COLLUSION AFFIDAVIT
00 45 19-1
DOCUMENT 00 45 19
NON-COLLUSION AFFIDAVIT
COMMONWEALTH OF:
COUNTY OF :
I,_______________________, of _____________________________, (Name) (Name of Contractor) in the County of _____________ and the State of ________________, of full age, being duly sworn according to law on my oath depose and say that:
I am of the firm of _______________________________________, the Bidder making the Proposal for the above Project, and that I executed the said Proposal with full authority so to do; that said Bidder has not, directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in connection with the above named Project; and that all statements contained in said Proposal and in this affidavit are true and correct, and made with full knowledge that the Montgomery Township relies upon the truth of the statements contained in said Proposal and in the statements contained in this affidavit in awarding the Contract for the said Project, the undersigned, on behalf of the Bidder, has not been convicted or found liable for any act prohibited by State or Federal law in any jurisdiction involving conspiracy or collusion with respect to bidding on any public contract within the last three (3) years.
A person's affidavit stating that the person has been convicted or found liable for any act, prohibited by State or Federal law in any jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract within the last three (3) years, does not prohibit a governmental agency from accepting a bid from or awarding a contract to that person, but may be a ground for administrative suspension or debarment at the discretion of a governmental agency under the rules and regulations of that agency, or, in the case of a governmental agency with no administrative suspension or debarment regulations or procedures, may be a ground for consideration on the question whether such agency should decline to award a contract to that person on the basis of a lack of responsibility.
I further warrant that no person or selling agency has been employed or retained to solicit or secure such contract upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, except bona fide employees or bona fide established commercial or selling agencies maintained by
(Name of Contractor)
(Signature)
(Print or Type Name and Title)
Subscribed and sworn to before me this _____ day of ________________, 20___.
Notary Public of
My commission expires _________________, 20___.
END OF DOCUMENT
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