4-00 45 19 Non Collusion Affidavit.pdf
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- Solicitation number
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- Northampton County, Pennsylvania
About this file
This is a Non-Collusion Affidavit form prepared by Herbert, Rowland & Grubic, Inc. for the Lower Mahanoy Township Municipal Authority's River Road Water Main Replacement Project (Contract 2026-01) in Lower Mahanoy Township, Northumberland County, Pennsylvania. The affidavit must be completed and sworn by an authorized representative of the bidding contractor. Bids for the general construction contract, which includes the replacement of a water main and associated appurtenances on River Road, are due online by June 10, 2026 at 2:00 PM local time. Bidding documents are available through the designated website at https://pennbid.bonfirehub.com/, and prospective bidders are encouraged to register as plan holders. All official notifications and addenda will be distributed exclusively through the designated website.
The Non-Collusion Affidavit requires the contractor to certify that the bid price has been independently determined without consultation, communication, or agreement with other bidders; that bid pricing has not been disclosed to competitors; that no inducements have been made to influence bidding practices; and that the bid is submitted in good faith without collusion. The affidavit further requires the contractor to disclose any convictions or findings of liability within the preceding four years related to conspiracy or collusion in public contract bidding. The completed affidavit must be notarized and submitted as part of the bid package. The issuing office for bidding documents is Herbert, Rowland & Grubic, Inc., located at 776 Bull Run Crossing, Suite 200, Lewisburg, PA 17837, with documents available for examination during business hours Monday through Friday between 9:00 AM and 3:00 PM.
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Text version
Herbert, Rowland & Grubic, Inc. 00 45 19 - 1 003207.0440
NON-COLLUSION AFFIDAVIT
STATE OF :
S.S.
COUNTY OF : CONTRACT NO.
I state that I am [Title] of [Contractor] and that I am authorized to make this affidavit on behalf of my firm, and its owners, directors, and officers. I am the person responsible in my firm for the price(s) and the amount of this bid.
I state that:
(1) The price(s) and amount of this bid have been arrived at independently and without consultation, communication or agreement with any other contractor, bidder or potential bidder.
(2) Neither the price(s) nor the amount of this bid, and neither the approximate price(s) nor approximate amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder, and they will not be disclosed before bid opening.
(3) No attempt has been made or will be made to induce any firm or person to refrain from bidding on this contract, or to submit a bid higher than this bid, or to submit any intentionally high or noncompetitive bid or other form of complementary bid.
(4) The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from, any firm or person to submit a complementary or other noncompetitive bid.
(5) _________________________________ (Contractor), its affiliates, subsidiaries, officers, directors and employees and have not, in the last four years, 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, except as follows:
I state that (Contractor) understands and acknowledges that the above representations are material and important, and will be relied on by the
______________________ (Owner) in awarding the contract(s) for which this bid is submitted. I understand and my firm understands that any misstatement in this affidavit is and shall be treated as fraudulent concealment from the (Owner) of the true facts relating to the submission of bids for this contract.
SWORN TO AND SUBSCRIBED BEFORE ME
THIS DAY OF Name and Company Position
Notary Public
Signature Date
(SEAL)
My Commission Expires:
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