8-Attachment B-Bidders Cert.pdf
PDF 134 KB Posted
- Attached to
- Twin Lakes SSPD Equipment Replacement
- Solicitation number
- PROJ-25-134
- Issued by
- Volusia County, Florida
About this file
This is a Bidder's Certification form (Attachment B) for Halifax Health Medical Center's Invitation to Bid (ITB) #PROJ-25-134, located in the State of Florida. The document serves as a required certification that bidders must complete and submit as part of their bid submission, though the specific products or services being procured, quantities, pricing, or contract terms are not detailed in this certification form.
The certification requires bidders to attest to several key compliance areas including receipt of complete bid documents, absence of collusive practices, adherence to equal opportunity employment laws, implementation of sexual harassment policies, and compliance with all applicable federal, state, and local regulations. Additionally, the form includes a tax certification section requiring notarization, where the bidder's executing officer must swear under oath that the company is not barred from contracting with Florida local government units due to tax delinquencies with the Florida Department of Revenue. The document requires company information, authorized official signatures, and notarization to be completed in 2025, but does not specify bid submission deadlines, contract values, or funding sources.
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Text version
ATTACHMENT B
HALIFAX HEALTH MEDICAL CENTER
BIDDER’S CERTIFICATION
ITB # PROJ-25-134
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-25-134
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 , 2025.
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 , 2025.
Notary Public
(SEAL)
File details come from the government source that posted it. Updated .