6-Attachment B-Bidders Cert.pdf
PDF 123 KB Posted
- Attached to
- Kitchen Cart Wash and Plumbing Modifications
- Solicitation number
- PROJ-26-070
- Issued by
- Volusia County, Florida
About this file
This is a Bidder's Certification form for Halifax Health Medical Center, a Florida healthcare facility, for Invitation to Bid (ITB) #PROJ-26-070 related to kitchen cart wash and plumbing modifications. The certification document requires bidders to confirm receipt of complete bid papers and commit to abiding by all contained information and requirements. Bidders must certify compliance with federal, state, and local laws regarding equal opportunity employment practices, confirm adoption of written sexual harassment policies in accordance with applicable regulations, and verify adherence to all relevant federal, state, and local codes, rules, ordinances, and statutes. Additionally, bidders must certify they have not engaged in collusion or unethical practices with any person, firm, or District employee.
The second page contains a Tax Certification section wherein the bidder's executing officer, under oath, certifies the truthfulness and accuracy of all statements made on behalf of the bidder and confirms authorization to execute the certification. The executing officer further certifies that the bidder is not barred from contracting with any unit of local government in Florida due to tax delinquency with the Florida Department of Revenue, unless the bidder is actively contesting its tax liability or the amount of tax owed through established statutory procedures. The form requires notarization and must be completed with the bidder's company name, address, official representative information, signature, date, telephone number, and email address.
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Text version
ATTACHMENT B
HALIFAX HEALTH MEDICAL CENTER
BIDDER’S CERTIFICATION
ITB # PROJ-26-070
I/We hereby certify that:
A. A complete set of bid papers, as intended, has been received, and I/We will abide by the contents and/or information received and/or contained herein.
B. I/We have not entered into any collusion or other unethical practices with any person, firm, or employee of the District which would in any way be construed as unethical practice.
C. I/We comply with all current federal, state and local laws, statutes, rules, and regulations referencing equal opportunity employment practices.
D. I/We have adopted a written sexual harassment policy which is in accordance with the requirements of federal, state and local laws, regulations and policies.
E. I/We will abide by all other federal, state and local codes, rules, regulations, ordinances and statutes.
COMPANY NAME
ADDRESS
DISTRICT/STATE/ZIP CODE
NAME OF CORPORATE/COMPANY OFFICIAL
(PLEASE TYPE OR PRINT CLEARLY)
TITLE
AUTHORIZED OFFICIAL SIGNATURE
DATE
TELEPHONE ( )
HALIFAX HEALTH MEDICAL CENTER
STATE OF FLORIDA
ITB # PROJ-26-070
COUNTY OF
BIDDER’S TAX CERTIFICATION
(BIDDER’S EXECUTING OFFICER), being first duly sworn on oath, deposes and states that all statements made herein are made on behalf of the Bidder, that this respondent is authorized to make them and that the statements contained herein are true and correct. Bidder deposes, states and certifies that Bidder is not barred from contracting with any unit of local government in the State of Florida as result of a delinquency in payment of any tax administered by the Florida Department of Revenue unless Bidder is contesting, in accordance with the procedures established by the appropriate statute, its liability for the tax or the amount of the tax.
DATED this day of , 2026.
By (Bidder’s Executing Officer)
(Name of Bidder’s Executing Officer)
(Title)
ATTEST/WITNESS:
By
Title
Subscribed and sworn to before me this day of , 2026.
Notary Public
(SEAL)
File details come from the government source that posted it. Updated .