6. RFB 25-26-03 Attachment F - Bid Certification Form.pdf

RFB 25-26-03 HRSGs Cleaning Services

RFB 25-26-03

ATTACHMENT F – BID CERTIFICATION FORM

HEAT RECOVERY STEAM GENERATORS (HRSGs) CLEANING SERVICES

Bidding Firm Name:

Address:

Telephone:

Facsimile:

E-mail:

Contact person name and title:

BIDDER REPRESENTATIONS

1. Bidder did not, in any way, collude, conspire or agree, directly or indirectly, with any person, firm, corporation or other Bidder in regard to the amount, terms, or conditions of this Bid.

2. Bidder additionally certifies that neither Bidder nor its principals are presently disbarred, suspended, proposed for disbarment, declared ineligible or voluntarily excluded from participation in this transaction by any federal department or agency, any California State agency, or any local governmental agency.

3. Bidder acknowledges that all requests for deviations, exceptions, and approved equals are enclosed herein and that only those deviations, exceptions, and approved equals included in the RFB document or permitted by formal addenda are accepted by the City.

4. Bidder did not receive unauthorized information from any City staff member or City Consultant during the Bid period except as provided for in the Request for Bids package, formal addenda issued by the City, or the pre-Bid conference.

5. As suppliers of goods or services to the City of Santa Clara, Bidder and individuals listed below certify that they do not discriminate in employment of any person because of race, sex, color, religion, religious creed, national origin, ancestry, age, gender, marital status, physical disability, mental disability, medical condition, genetic information, sexual orientation, gender expression, gender identity, military and veteran status, or ethnic background; and that they are in compliance with all Federal, State and local laws, directives and executive orders regarding nondiscrimination in employment.

6. Bidder hereby certifies that the information contained in the Bid and all accompanying documents is true and correct.

RFB 25-26-03 HRSGs Cleaning Services

7. Please check the appropriate box below:

If the Bid is submitted by an individual, it shall be signed by him or her, and if he or she is doing business under a fictitious name, the Bid shall so state.

If the Bid is submitted by a partnership, the full names and addresses of all members and the address of the partnership, the full names and addresses of all members and the addresses of the partnership, the full names and addresses of all members and the address of the partnership shall be stated and the Bid shall be signed for all members by one or more members thereof.

If the Bid is submitted by a corporation, it shall be signed in the corporate name by an authorized officer or officers.

If the Bid is submitted by a limited liability company, it shall be signed in the corporate name by an authorized officer or officers.

If the Bid is submitted by a joint venture, the full names and addresses of all members of the joint venture shall be stated and it shall be signed by each individual.

By signing below, the submission of a Bid with all accompanying documents shall be deemed a representation and certification by the Bidder that they have investigated all aspects of the RFB, that they are aware of the applicable facts pertaining to the RFB process, its procedures and requirements, and that they have read and understand the

RFB.

Authorized Representative Name (print name):

Signature (sign name):

Title (print title):

Complete additional signatures below as required per # 7 above