5-No Collusion Affidavit by Contractor Fill Form.pdf
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- Solicitation number
- RFB-25-364 Upgrade Pavement Markings 4 Citywide Locations
- Issued by
- Yuma County, Arizona
About this file
This is a No Collusion Affidavit form required by the City of Yuma, Arizona for contractors bidding on the RFB-25-364 Upgrade Pavement Markings 4 Citywide Locations project. The affidavit certifies compliance with Arizona Revised Statutes Section 34-253 and requires bidders to confirm that pricing was developed independently without collusion, consultation, communication, or agreement with other bidders or competitors. Bidders must attest that bid prices have not been disclosed to competitors prior to bid opening and that no attempts have been made to induce other parties to submit or withhold bids. The project involves upgrading pavement markings and related work at four citywide locations including 32nd Street (from Avenue D to Avenue C and from Avenue B to 4th Avenue), 16th Street (from Avenue D to Pacific Avenue), and 3rd Street/Giss Parkway (from Avenue B to Main Street).
The affidavit must be executed under penalty of perjury before a notary public in the State of Arizona. Bidders certify that neither they nor anyone associated with their business has expended or will expend money to influence any member of the Yuma Council, City department, or employee in connection with contract award. The form requires the contractor's signature, title, and business name, along with notarization with the notary public's commission expiration date. This certification is a mandatory submission requirement for all bids and serves as a safeguard against fraudulent bidding practices and anti-competitive behavior.
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Text version
July 2020
AFFIDAVIT BY CONTRACTOR
CERTIFYING THAT THERE WAS
NO COLLUSION IN BIDDING FOR CONTRACT
BEING DULY SWORN, DEPOSES AND SAYS:
That he/she is of .
(Title) (Name of Business)
That pursuant to Section 34-253 of the Arizona Revised Statutes, he/she certifies as follows:
That neither he nor anyone associated with the said (Name of Business) has 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 this Project.
AND FURTHER that CONTRACTOR has not expended nor will expend any money to influence any member of YUMA Council, a YUMA Department or a YUMA employee in connection with the award of this Contract.
By submission of this bid, bidder and on behalf of bidder certifies, and in the case of joint bid, each party thereto certifies as to its own organization, under penalty of perjury, that to the best of his/her knowledge and belief:
(1) The prices of this bid have been arrived at independently, without collusion, consultation, communication, or agreement with any other Bidder or competitor, for the purposes of restricting competition or as to any matter relating to price.
(2) Unless otherwise required by law, the prices quoted in this bid have not been knowingly disclosed by Bidder and will not be disclosed by Bidder directly or indirectly to any other bidder or competitor before bids are opened.
(3) No attempt has been made or will be made by the Bidder to induce any other person, partnership or corporation to submit or not to submit a bid on any portion of the Project work.
(Signature)
(Title)
(Name of Business)
STATE OF ARIZONA )
) ss. ___________________________________
County of ) (Name of Individual signed above)
Subscribed to under penalty of perjury under the laws of the State of Arizona, this _____ day of
________________, 20____ as the act and deed of said Company.
Notary Public
My commission expires: __________________
| Name of Individual signed above: |
| Subscribed to under penalty of perjury under the laws of the State of Arizona this: |
| 20: |
| as the act and deed of said Company: |
| My commission expires: |
| Name of Business: |
| Title: |
| Contract Title: Transportation Management Center (TMC) |
File details come from the government source that posted it. Updated .