5-Part G - Attachment A - Authorized Signatory Statement.pdf
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- Solicitation number
- 2037
- Issued by
- Alexandria City, Virginia
About this file
This is an Authorized Signatory Statement attachment for a Request for Proposals (RFP No. 2037) issued by the City of Alexandria, Virginia, for Transportation Services for the DOT Paratransit Program and City Programs. The document serves as a certification form that must be completed and signed by an authorized representative of the responding organization. The signatory must confirm authority to submit the proposal on behalf of the respondent and bind the organization to all representations and requirements outlined in the solicitation documents. Respondents are required to acknowledge that they have read, understood, and agree to comply with all solicitation requirements, including instructions, specifications, scope, evaluation criteria, applicable terms and conditions, and all issued addenda.
The statement requires respondents to certify multiple compliance matters including independent submission without collusion with other respondents, adherence to ethics in public contracting standards, maintenance of a drug-free workplace where applicable under Virginia law, and accuracy of all submitted information. Respondents must also certify that no gratuities, kickbacks, or things of value have been offered to any City employee or official in connection with the solicitation. The form includes signature blocks for authorized signatories with fields for printed name, title, respondent legal name, address, and contact information. False certifications may subject respondents to criminal and civil penalties, and material misrepresentations may result in response rejection, termination of negotiations, termination for default, or other remedies available to the City.
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City of Alexandria
Attachment A Authorized Signatory Statement
By signing below, the undersigned certifies and represents that:
1. Authority / Binding Offer: The undersigned is an officer, partner, member, manager, or duly authorized agent of the Respondent with full authority to submit this Response on behalf of the Respondent and to bind the Respondent to the representations made herein and to the requirements of this Solicitation.
2. Validity of Response: This Response constitutes a firm and valid submission for evaluation purposes and shall remain effective for the period stated in the Solicitation Documents, or, if no period is stated, for a reasonable period as determined by the City.
3. Acknowledgment of Solicitation Requirements: The Respondent acknowledges that it has read, understands, and agrees to comply with all requirements of the Solicitation Documents, including all instructions, specifications or scope, evaluation criteria, applicable terms and conditions, and all addenda issued by the City (as acknowledged by the Respondent).
4. No Collusion / Independent Submission: The Respondent certifies that this Response has been prepared and submitted independently and without collusion, consultation, communication, or agreement with any other respondent, bidder, or offeror regarding prices, qualifications, intent to submit, or response terms, except as expressly permitted by law. The Respondent understands that false certification may subject it to criminal and civil penalties.
5. Ethics in Public Contracting: The Respondent certifies that it has not offered, given, or agreed to give any City employee or official any gratuity, kickback, or thing of value in connection with this Solicitation and will comply with all applicable ethics in public contracting requirements
6. Drug-Free Workplace (when applicable): Where required by Virginia law and/or the Solicitation Documents, the Respondent certifies that it will provide and maintain a drug-free workplace during performance of any resulting contract and will include the required provisions in subcontracts.
7. Accuracy / Non-Misrepresentation: The Respondent certifies that all information submitted in its Response is true, complete, and accurate, and to the best of its knowledge and acknowledges that any material misrepresentation may result in rejection of the Response, termination of negotiations, termination for default, and/or other remedies available to the City.
Authorized Signature: Date:
Printed Name: Title:
Respondent Legal Name:
Address:
Phone/Email: _________________________________________________________________
| Date: |
| Printed Name: |
| Title: |
| Respondent Legal Name: |
| Address: |
| PhoneEmail: |
| Signature1_es_:signer:signature: |
| Solicitation Type: Request for Proposal |
| Solicitation Name_es_:sender: RFP No. 2037 |
| Solicitation No_es_:sender: |
| Solicitation Abbreviation_es_:sender: |
File details come from the government source that posted it. Updated .