5-Non-Collusion Affidavit of Prime Bidder.pdf
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- Solicitation number
- US.260533
- Issued by
- Montgomery County, Pennsylvania
About this file
This document is a Non-Collusion Affidavit of Prime Bidder form required by Lower Gwynedd Township, a municipality in Montgomery County, Pennsylvania, for traffic signal infrastructure projects. The affidavit serves as a sworn certification submitted by a bidder's authorized representative confirming the genuineness of the bid and the absence of collusive practices in the bidding process. Bidders must submit this form as part of their proposal package for any of the three traffic signal projects advertised: traffic signal pole replacement at Bethlehem Pike and Penllyn Pike (due October 10, 2025), traffic signal and ADA improvements at Penllyn Pike and Trewellyn Avenue/Old Penllyn Pike (due July 17, 2026), or traffic signal maintenance services for two years with an optional one-year extension (due November 30, 2026). Bids must be submitted exclusively through PennBID's online platform, and all bidders must be PennDOT pre-qualified contractors.
The affidavit requires the bidder's representative to swear under oath that the submitted bid is genuine, that no collusion or conspiracy exists between the bidder and any other party regarding bid pricing, bid withdrawal, or competitive advantage, and that all prices quoted are fair and proper without any unlawful agreement. The document must be notarized and include the bidder's name, the representative's signature and title, the county where the affidavit is sworn, the date, and the notary's commission expiration date. This form is a standard compliance requirement for Pennsylvania public works projects subject to prevailing wage requirements and pre-qualification regulations, with no pricing information or set-asides contained within the affidavit itself.
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Text version
- 12 -
D. NON-COLLUSION AFFIDAVIT OF PRIME BIDDER
State of ) County of ) ) ss:
being duly sworn, deposes and says that:
(Name of Bidder’s Representative)
1) He is (Capacity of Bidder’s Representative – i.e., Owner, partner, officer, agent, etc.)
of (Name of Bidder)
2) He is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid;
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 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, firm or person to fix the price or prices in the agreement or collusion or communication or conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder, or, to fix any overhead, profit or cost element of the bid price or the bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the Owner to which the attached Bid is being submitted or any person interested in the proposed Contract; and
5) The price or prices quoted in the attached Bid are fair and proper and are 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.
(Name of Bidder)
(Signature of Bidder’s Representative)
(Title of Bidder’s Representative)
Sworn to and subscribed before me this day of , A.D. 20 .
(Signature of Notary)
My Commission Expires: .
(Title) (Date)
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