4-Certification Addenda Acknowledgement Form.pdf
PDF 123 KB Posted
- Solicitation number
- RFQ-26-180 Professional Design Services for 40th Street: Avenue 6E to 7E
- Issued by
- Yuma County, Arizona
About this file
This is a Certification & Addenda Acknowledgement Form issued by the City of Yuma, Arizona Procurement Division on November 6, 2024, for the RFQ-26-180 Professional Design Services solicitation. The form pertains to professional design services for the construction of a new segment of 40th Street extending from Avenue 6E to Avenue 7E, designed as a Minor Arterial roadway with four travel lanes, left and right turn lanes where necessary, curb and gutter, sidewalk on the south side, and a 10-foot-wide multi-use path on the north side. The project scope includes infrastructure work encompassing grading, drainage, paving, raised median, traffic signals at both Avenue 6E and 7E intersections, an at-grade signalized intersection at State Route 195, lighting, and Arizona Public Service power services. The City has provided preliminary Design Concept Report, Traffic Analysis, Environmental Considerations, and draft 15% plans with the solicitation, with the project currently scheduled for construction advertisement in Fiscal Year 2028.
Responders are required to acknowledge receipt and consideration of all solicitation documents and any addenda posted on the City of Yuma's Bonfire Procurement Portal. The form certifies that responding companies will comply with all solicitation requirements and confirms authority to bind the organization to the contract. Responders must affirm non-discrimination in employment practices in compliance with Federal Executive Order 11246 and Arizona Revised Statutes Section 3101461 Et. Seq., and certify that no improper inducements have been offered to public servants in connection with the bid submission. The City bears no responsibility for responders who fail to monitor the portal for addenda updates.
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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: RFQ-26-180 |
| Ref 2: Professional Design Services for 40th Street: Avenue 6E to 7E |
| 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 .