8-Affidavit of Accuracy Signature Page.docx
DOCX document 37 KB Posted
- Solicitation number
- RFQ 265X901171
- Issued by
- Hamilton County, Ohio
About this file
This document is an Affidavit of Accuracy and Signature Page for a Qualifications Questionnaire submitted in response to RFQ #265x901171 issued by the Mississippi State Department of Health, Commodity and General Services (MSDGC) for Owner's Advisor and Design Services related to the Mercy West Advanced Treatment System (MWATS) project in Ohio. The affidavit requires the authorized representative of the Offeror to swear or affirm under penalty of perjury that no collusion has occurred among parties seeking unfair advantage, and that all information contained in the submittal is true, complete, and not misleading. The Offeror must also represent that it has reviewed and thoroughly understands the scope of work, terms, and conditions set forth in the RFQ and draft agreement, has made due inquiry regarding any issued addenda, and accepts full responsibility for receipt of all addenda. The document emphasizes that addenda issued by MSDGC shall become part of the RFQ upon issuance and that failure to receive any addendum does not relieve the Offeror of responsibility for incorporating its provisions.
The signature page requires the full legal name of the Offeror, the name and title of the authorized representative, and the signature and date of that representative, along with notarization. Offerors must attach documentation of signatory authorization appropriate to their legal entity type, including corporate resolutions for corporations (dated within 12 months of the submittal deadline), operating agreements for LLCs, or partnership agreements for partnerships. Templates for corporate resolutions are available on both the City of Cincinnati's Open Data website and the MSDGC website via Bonfire portal. Corporations are required to submit the certificate of corporate resolution with their submittals, either by completing the template provided or submitting an existing certificate meeting all template requirements.
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| File | Type | Posted |
|---|---|---|
| 7-Att 5.docx | DOCX document | |
| 16-Corporate Resolution 2 Authorized to Sign - Instructions.pdf | ||
| 6-Att 1.docx | DOCX document | |
| 10-RFP-Q Subconsultant Utilization Plan.pdf.pdf | ||
| 1-Complete QQ 265x901171 - Att. 0-5 AA.docx | DOCX document | |
| 15-AFFIDAVIT CONCERNING AUTHORITY (template).docx | DOCX document | |
| 4-Att 2.docx | DOCX document | |
| 18-AMR Treatment at Mercy West Pump Station Initial Project Concept.pdf | ||
| 5-Att 4.docx | DOCX document | |
| 17-PA-Draft 2026.pdf | ||
| 3-Att 3.docx | DOCX document | |
| 14-AFFIDAVIT CONCERNING AUTHORITY (Instructions).pdf | ||
| 2-RFQ 265X901171.pdf | ||
| 12-CorporateResolution2AuthorizedtoSign.doc | DOC document | |
| 9-Att 0.docx | DOCX document | |
| 19-Mercy West PS - Drawings.pdf | ||
| 11-Professional Services Small Business Enterprise Rating Rubric 11.6.19.pdf | ||
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Text version
MSDGC QUALIFICATIONS QUESTIONNAIRE FOR RFQ # RFQ 265x901171
OWNER’S ADVISOR AND DESIGN SERVICES
AFFIDAVIT OF ACCURACY & SIGNATURE PAGE
The undersigned swears or affirms under the penalty of perjury that the Offeror, its agents, servants and/or employees, to the best of his/her knowledge and belief, have not in any way colluded with anyone for and on behalf of the Offeror an unfair advantage over others, nor have they colluded with anyone for and on behalf of the Offeror, or themselves, to gain any favoritism in the award of any contract resulting from this Request for Qualifications (“RFQ”).
The undersigned further swears or affirms, to the best of his or her knowledge and belief, that the information contained in the submittal to this RFQ (“Submittal”), which is defined to include any information on the Qualifications Questionnaire (“QQ”), all attachments, exhibits and forms, is true and complete, and that the Offeror has not omitted any fact necessary to make the information contained in the submittal to this RFQ not misleading.
The Offeror’s submission of qualifications in response to this RFQ shall constitute a representation on its part that the Offeror (a) has reviewed and thoroughly understands the scope of work, terms and conditions set forth in this RFQ and draft agreement; (b) has made due inquiry to MSDGC as to the existence of any addenda issued in connection with this RFQ; (c) is satisfied that it has received any and all such addenda and has taken the contents thereof into consideration when preparing and submitting the Submittal; (d) understands all addenda will be issued via the MSDGC website and (e) accepts full and complete responsibility for the receipt of any and all such addenda and waives any claim of mistake or error in this Submittal based upon its failure, in fact, to have received any one or more addenda. The Offeror’s failure to receive any addenda shall in no event relieve the Offeror from any responsibility for incorporating the provisions of the addenda into its Submittal. Addenda, upon issuance by MSDGC, shall be deemed to have become a part of this RFQ to the same extent as if set fourth fully therein.
Full, Legal Name of Offeror
Name of Authorized Representative1
Title of Authorized Representative1
Signature of Authorized Representative1
Date
State of:
County of:
Sworn to and subscribed in my presence this _________ day of _________________, 2024 by
| My commission expires: | _________________________________________________ | |
| Notary Public |
1Offeror must attach documentation of signatory authorization appropriate to the Offeror’s legal entity type, as identified in Attachment 0. Such documentation includes: corporate resolution (for corporations); operating agreement indicating authorized signatory(ies) (for LLCs); partnership agreement setting out who can act for the partnership (for partnerships). A template for a certificate of corporate resolution is available on the City’s “Open Data” website at https://data.cincinnati-oh.gov/.
A template for a certificate of corporate resolution is available on the City of Cincinnati’s Bonfire portal at https://cincinnati-oh.bonfirehub.com/. Corporations must submit the certificate of corporate resolution with their submittals. They may complete and submit the certificate of corporate resolution template provided on the MSDGC website or submit a current existing certificate of corporate resolution that is dated within 12 months of the submittal deadline and contains all the elements included in the corporate resolution template that is provided on the MSDGC website.
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