8-Attachment B-Bidders Cert.pdf
PDF 133 KB Posted
- Solicitation number
- PROJ-26-022
- Issued by
- Volusia County, Florida
About this file
This is a Bidder's Certification form for Halifax Health Medical Center related to ITB #PROJ-26-022 for Unit 200 Remediation at Halifax Behavioral Services in Florida. The certification document requires bidders to affirm receipt of complete bid papers and commit to abiding by all terms and conditions contained within the solicitation materials. Bidders must certify compliance with federal, state, and local laws governing equal opportunity employment practices and confirm adoption of a written sexual harassment policy consistent with applicable legal requirements. Additionally, bidders must acknowledge adherence to all applicable federal, state, and local codes, rules, regulations, ordinances, and statutes.
The form includes a tax certification section in which the bidder's authorized executing officer must swear under oath that all statements are true and correct and made on behalf of the bidder. Critically, bidders must certify that they are not barred from contracting with any unit of local government in Florida as a result of tax delinquency with the Florida Department of Revenue, unless the bidder is actively contesting the tax liability or amount through established statutory procedures. The certification requires the signature of an authorized corporate or company official, the company name and address, contact information including telephone and email, and notarization of the tax certification section. This document serves as a prerequisite compliance certification that must be submitted as part of the bid response.
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Text version
ATTACHMENT B
HALIFAX HEALTH MEDICAL CENTER
BIDDER’S CERTIFICATION
ITB # PROJ-26-022
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-26-022
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)
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