4-NONCOLLUSION AFFIDAVIT.pdf
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- Solicitation number
- 2026019-BID5100 Hunter’s Ridge Lift Station Replacement
- Issued by
- Clayton County, Georgia
About this file
This is a Non-Collusion Affidavit form required by Columbia County, Georgia for bid submissions on state and local contract opportunities, specifically for the Hunter's Ridge Lift Station Replacement project (Project Number 2026019-BID5100). The affidavit must be completed and sworn by an authorized representative of the bidding company, certifying that the bid submission is genuine and that no collusive or anti-competitive practices have occurred in the preparation or submission of the bid.
The affidavit requires the bidder to attest, under oath before a notary public, that the bid complies with Georgia Code O.C.G.A. 36-91-21(e) and that neither the bidder nor any of its officers, partners, owners, agents, representatives, or employees has engaged in collusion, conspiracy, or unlawful agreement with any other bidder to fix pricing, manipulate overhead or profit elements, or secure unfair advantage against Columbia County or other interested parties. The signatory must also confirm that all quoted prices are fair, proper, and untainted by any collusive practices. The form requires completion of standard notarization elements including the notary seal and commission expiration date.
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Text version
Columbia County NCA-1 NON-COLLUSION AFFIDAVIT
NON-COLLUSION AFFIDAVIT OF BIDDER
State of Georgia
County of
I, (name of individual), being first duly sworn, deposes and says that:
(1) He is ___________________________ (title) of ______ ______________ (Company) the Bidder that has submitted the Bid on the following;
Project Name:
Project Number:
(2) He makes an oath that O.C.G.A. 36-91-21 (e) has not directly or indirectly been violated;
(3) Such Bid is genuine and is not a collusive or sham Bid;
(4) Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees, or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, or to fix any overhead, profit or cost element of the Bid price or the Bid of any other bidder, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the Columbia County, Georgia or any person interested in the proposed Contract; and
(5) The price or prices quoted in the attached Bid are fair and proper and not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties in interest, including this affiant.
(Signed)___________________________________
Title______________________________________
Subscribed and sworn to before me, This day of , 20__
Notary Public:
(Notary Seal)
My commission expires:
Columbia
| County of: |
| I: |
| 1 He is: |
| Project Name: |
| Project Number: |
| Signed: |
| Title: |
| This: |
| day of: |
| Notary Public: |
| My commission expires 1: |
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