3-Non-Collusion Statement -Attachment 2.pdf
PDF 381 KB Posted
- Solicitation number
- HSS-26-008
- Issued by
- New Castle County, Delaware
About this file
This is a Non-Collusion Statement form for the State of Delaware, Division of Public Health, issued in connection with Contract No. HSS-26-008 for Alliance for Adolescent Pregnancy Prevention Services. The Alliance for Adolescent Pregnancy Prevention (AAPP) program, established in 1995, coordinates statewide initiatives to prevent adolescent pregnancy and reduce sexually transmitted disease and HIV/AIDS risks across Delaware's three counties. The program implements evidence-based curricula delivered by trained facilitators to engage adolescents in high-risk areas, with goals to increase utilization of school- and community-based prevention services, enhance sexual and reproductive health literacy among adolescents and families, and reduce racial, ethnic, and geographic-based sexual health disparities. The deadline to respond to this solicitation is January 29, 2026, at 1:00 PM EST/EDT.
The Non-Collusion Statement certifies that the vendor has not engaged in collusion or restraint of free competitive bidding and has not submitted as a sub-contractor while the parent company also submitted as a primary vendor. Vendors must indicate their authorized representative legally empowered to execute contracts with the State of Delaware and provide company classification information, including certifications as Minority Business Enterprise (MBE), Woman Business Enterprise (WBE), Disadvantaged Business Enterprise (DBE), Veteran Owned Business Enterprise (VOBE), or Service-Disabled Veteran Owned Business Enterprise (SDVOBE). Vendors must also affirm whether their firm, affiliates, predecessor entities, or principals have been subject to federal, state, or local government suspension or debarment within the past five years, with explanation required if applicable.
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
Delaware Health and Social Services Division of Public Health
Attachment 2
CONTRACT NO.: HSS-26-008
CONTRACT TITLE: Alliance for Adolescent Pregnancy Prevention Services DEADLINE TO RESPOND: January 29, 2026, at 1:00 PM EST/EDT
NON-COLLUSION STATEMENT (COMPLETE THIS FORM IN ITS ENTIRELY)
This is to certify that the undersigned Vendor has neither directly nor indirectly, entered into any agreement, participated in any collusion or otherwise taken any action in restraint of free competitive bidding in connection with this proposal, and further certifies that it is not a sub-contractor to another Vendor who also submitted a proposal as a primary Vendor in response to this solicitation submitted this date to the State of Delaware, Division of Public Health.
It is agreed by the undersigned Vendor that the signed delivery of this bid represents, subject to any express exceptions set forth at Attachment 3, the Vendor’s acceptance of the terms and conditions of this solicitation including all specifications and special provisions.
NOTE: Signature of the authorized representative MUST be of an individual who legally may enter his/her organization into a formal contract with the State of Delaware, Division of Public Health.
COMPANYNAME (Check one)
NAME OF AUTHORIZED REPRESENTATIVE
(Please type or print)
SIGNATURE TITLE
COMPANY ADDRESS
PHONE NUMBER FAX NUMBER
EMAIL ADDRESS ______________________________
STATE OF DELAWARE
FEDERAL E.I. NUMBER LICENSE NUMBER_____________________________
COMPANY
CLASSIFICATIONS:
CERT. NO.:
Certification type(s) Circle all that apply
Minority Business Enterprise (MBE) Yes No Woman Business Enterprise (WBE) Yes No Disadvantaged Business Enterprise (DBE) Yes No Veteran Owned Business Enterprise (VOBE) Yes No Service-Disabled Veteran Owned Business Enterprise (SDVOBE) Yes No
[The above table is for informational and statistical use only.]
PURCHASE ORDERS SHOULD BE SENT TO:
(COMPANY NAME)
ADDRESS
CONTACT
PHONE NUMBER FAX NUMBER
EMAIL ADDRESS
AFFIRMATION: Within the past five years, has your firm, any affiliate, any predecessor company or entity, owner, Director, officer, partner or proprietor been the subject of a Federal, State, Local government suspension or debarment?
YES NO if yes, please explain
Corporation Partnership Individual
File details come from the government source that posted it. Updated .