4-DOC 00 45 19 NON-COLLUSION AFFIDAVIT.pdf
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- Solicitation number
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- Issued by
- Montgomery County, Pennsylvania
About this file
This Non-Collusion Affidavit is a required submission document for bidders responding to Montgomery Township procurement solicitations in Pennsylvania. The affidavit serves as a sworn statement in which the bidder's authorized representative certifies that the bidder has not engaged in collusion, conspiracy, or any agreement that restrains free and competitive bidding on the project. The affidavit must be notarized and submitted as part of the bid package for projects including the Bethlehem Pike Emergency Pre-Emption Detection installation, Rectangular Rapid Flashing Beacon and Pedestrian Improvements along Stump Road, Signal Modernization at Bethlehem Pike and Gwynedd Crossing Drive, Whistlestop Park rehabilitation, and the John Deere 6120M Tractor equipment supply and installation contract. The affidavit requires the contractor to warrant that no commissions, percentages, brokerage fees, or contingent fees have been paid to secure the contract, except through bona fide employees or established commercial selling agencies of the contractor.
The affidavit additionally requires certification that the bidder and its representatives have not been convicted or found liable within the past three years for any act prohibited by state or federal law involving conspiracy or collusion with respect to bidding on public contracts. While a prior conviction or finding of liability does not automatically prohibit bid acceptance, it may serve as grounds for administrative suspension, debarment, or consideration of contractor responsibility at Montgomery Township's discretion. The affidavit must be executed by an officer or authorized representative of the bidding firm and notarized before submission, with the notary's commission expiration date clearly indicated on the document.
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Text version
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
NON-COLLUSION AFFIDAVIT
00 45 19-1
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