6-HSS-26-047- Attachment 2 - Non-Collusion Stmt.docx
DOCX document 129 KB Posted
- Attached to
- BEHAVIORAL HEALTH NUTRITION SERVICES
- Solicitation number
- HSS-26-047
- Issued by
- Delaware
About this file
This is a Non-Collusion Statement form for Contract No. HSS-26-047, issued by the Delaware Health and Social Services Division of Substance Abuse and Mental Health. The solicitation seeks to procure Behavioral Health Nutrition Services from a qualified healthcare provider experienced in addressing the interconnected cycle of serious mental illness, substance use disorders, and nutritional deficiencies. The contract recognizes that substance use impairs nutrient absorption and exacerbates psychiatric symptoms, while poor nutrition increases vulnerability to both serious mental illness and addiction. Integration of nutrition services into treatment and recovery support protocols is intended to restore neurochemical balance, support cognitive recovery, and mitigate cravings to enhance clinical outcomes. The deadline to submit a proposal is March 5, 2026, at 1:00 PM EST.
The Non-Collusion Statement requires the authorized representative of the bidding organization to certify that the vendor has not engaged in any collusion or anticompetitive behavior in connection with the proposal and is not a subcontractor to another vendor submitting a primary proposal. Vendors must complete company information fields, including company name, authorized representative details, federal E.I. number, and license number. The form requests disclosure of minority business enterprise (MBE), woman business enterprise (WBE), disadvantaged business enterprise (DBE), veteran-owned business enterprise (VOBE), and service-disabled veteran-owned business enterprise (SDVOBE) certifications. Vendors are required to disclose whether their firm, any affiliate, predecessor company, owner, director, officer, partner, or proprietor has been subject to federal, state, or local government suspension or debarment within the past five years.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Delaware Health and Social Services
Division of Substance Abuse and Mental Health d
Delaware Health and Social Services
Division of Substance Abuse and Mental Health d
Attachment 2
| CONTRACT NO.: | HSS-26-047 |
| CONTRACT TITLE: | BEHAVIORAL HEALTH NUTRITION SERVICES |
DEADLINE TO RESPOND: Due 03/05/2026, at 1:00 PM EST
NON-COLLUSION STATEMENT
This is to certify that the undersigned Vendor has neither directly nor indirectly, entered into any agreement, participated in any collusion or otherwise taken any action in restraint of free competitive bidding in connection with this proposal, and further certifies that it is not a sub-contractor to another Vendor who also submitted a proposal as a primary Vendor in response to this solicitation submitted this date to the State of Delaware, Division of Substance Abuse and Mental Health
It is agreed by the undersigned Vendor that the signed delivery of this bid represents, subject to any express exceptions set forth at Attachment 3, the Vendor’s acceptance of the terms and conditions of this solicitation including all specifications and special provisions.
NOTE: Signature of the authorized representative MUST be of an individual who legally may enter his/her organization into a formal contract with the State of Delaware, Division of Substance Abuse and Mental Health.
Corporation
Partnership
Individual
COMPANY NAME __________________________________________________________________Check one)
NAME OF AUTHORIZED REPRESENTATIVE
(Please type or print)
SIGNATURE TITLE
COMPANY ADDRESS
PHONE NUMBER FAX NUMBER
| EMAIL ADDRESS | ______________________________ | ||
| STATE OF DELAWARE | |||
| FEDERAL E.I. NUMBER | LICENSE NUMBER_____________________________ |
COMPANY CLASSIFICATIONS:
CERT. NO.: __________________
| Certification type(s) |
| Circle all that apply |
| Minority Business Enterprise (MBE) | |
| Yes | No |
| Woman Business Enterprise (WBE) | |
| Yes | No |
| Disadvantaged Business Enterprise (DBE) | |
| Yes | No |
| Veteran Owned Business Enterprise (VOBE) | |
| Yes | No |
| Service Disabled Veteran Owned Business Enterprise (SDVOBE) | |
| Yes | No |
[The above table is for informational and statistical use only.]
PURCHASE ORDERS SHOULD BE SENT TO:
(COMPANY NAME)
ADDRESS
CONTACT
PHONE NUMBER FAX NUMBER
EMAIL ADDRESS
AFFIRMATION: Within the past five years, has your firm, any affiliate, any predecessor company or entity, owner, Director, officer, partner or proprietor been the subject of a Federal, State, Local government suspension or debarment?
YES NO if yes, please explain image1.png image2.png
File details come from the government source that posted it. Updated .