7-HSS-26-026- Attachment 2 - Non-Collusion Stmt.docx
DOCX document 129 KB Posted
- Attached to
- Syringe Services Program
- Solicitation number
- HSS-26-026
- Issued by
- Delaware
About this file
This document is a Non-Collusion Statement for the Delaware Health and Social Services Division of Substance Abuse and Mental Health (DSAMH) related to the Syringe Services Program contract (HSS-26-026). The solicitation is due on 10/20/2025 at 1:00 PM EST and seeks a provider to implement harm reduction programming for people who use drugs (PWUD) and injection drug users (IDU). The contract requires the selected vendor to certify that they have not engaged in any collusive bidding practices and are legally authorized to enter into a formal contract with the State of Delaware.
The document includes a comprehensive vendor classification section that allows bidders to identify themselves across multiple business enterprise categories, including 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). The solicitation is contextualized by Delaware's public health environment, which includes 3,786 people living with HIV/AIDS as of 2021, highlighting the critical nature of the syringe services harm reduction program. Vendors must complete the non-collusion statement, provide company details, and affirm they have not been subject to federal, state, or local government suspensions or debarments within the past five years.
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Other files
| File | Type | Posted |
|---|---|---|
| 6-HSS-26-026 - Statewide Syringe Services Program final 9.11.25.docx | DOCX document | |
| 3-HSS-26-026 Drug Court Diversion Services - Attachment 6 - Subcontractor Information Form.docx | DOCX document | |
| 5-HSS-26-026 Appendix D - Templates Sample Agreements.docx | DOCX document | |
| 2-HSS-26-026 Drug Court Diversion Services - Attachment 5 - Business References Form.docx | DOCX document | |
| 4-HSS-26-026 Drug Court Diversion Services - Attachment 4 - Confidential Information Form.docx | DOCX document | |
| 8-HSS-26-026 - Attachment 3 - Exceptions Form.docx | DOCX document | |
| 1-Appendix - Budget Workbook.xlsx | XLSX spreadsheet |
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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-26-026 |
| CONTRACT TITLE: | Syringe Services Program |
DEADLINE TO RESPOND: Due 10/20/2025, 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
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