3-Non-Collusion Affidavit.pdf
PDF 93 KB Posted
- Attached to
- Art Supplies and Related Materials
- Solicitation number
- IFB 27-03-31
- Issued by
- Maricopa County, Tucson City, Arizona
About this file
This is a Non-Collusion Affidavit required for the Tolleson Union High School District #214 and S.A.V.E. Cooperative Purchasing members' Art Supplies and Related Materials contract opportunity in Arizona. The affidavit must be completed and notarized by the person authorized to sign the proposal on behalf of the bidding contractor, offeror, person, corporation, or company submitting a proposal. The document certifies that the proposal is genuine and not collusive, that the offeror has not induced or solicited other offerors to submit sham proposals or refrain from bidding, and that no collusive measures have been taken to secure unfair advantage over competing bidders.
The affidavit further requires the offeror to affirm that it has exercised due diligence to ensure no personal gifts or benefits have been offered, conferred, or agreed to be conferred to any person supervising or participating in contracts, purchases, payments, claims, or other financial transactions related to the District, or to any person involved in planning, recommending, selecting, or contracting for materials, services, goods, or construction services. Compliance with Arizona Revised Statutes Section 15-213(O), Arizona Administrative Code Rules 7-2-1042(A.1.L), and 7-2-1003(J) is required. The form must be notarized before a notary public and includes standard fields for the affiant's name, title, state, county, date, and notary signature.
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Text version
NON-COLLUSION AFFIDAVIT
State of ____________________ )
) ss.
County of __________________ )
Before me, the undersigned, personally appeared
______________________________________________________________________ , affiant, (Name) the _____________________________________________________________________________ (Title)
(Contractor/Offeror) the persons, corporation, or company who makes the accompanying Proposal, having first been duly sworn, deposes and says:
That such Proposal is genuine and not sham or collusive, nor made in the interest of, or behalf of, any persons not herein named, and that the Offeror has not directly or indirectly induced or solicited any other Offeror to put in a sham Proposal, or any other person, firm or corporation to refrain from submitting a Proposal, and that the Offeror has not in any manner sought by collusion to secure for itself an advantage over any other Offeror; and
That Offeror has taken steps and exercised due diligence to ensure that Offeror has not offered, conferred, or agreed to confer any personal gift or benefit on a person who supervises or participates in contracts, purchases, payments, claims or other financial transactions, or on a person who supervises or participates in planning, recommending, selecting or contracting for materials, services, goods, construction or construction services of the District, in accordance with A.R.S. § 15-213(O), A.A.C. R7-2-1042(A.1.L), and A.A.C. R7-2-1003(J).
(Signature of Affiant)
(Title)
Subscribed and sworn to before me this __________ day of ___________________________ , 20 ____________
Signature of Notary Public in and for the
State of ___________________________________________
County of _________________________________________
THIS FORM MUST BE NOTARIZED
File details come from the government source that posted it. Updated .