8-FORM 5 - NON COLLUSION AFFIDAVIT OF RESPONDENT.pdf
PDF 1 MB Posted
- Attached to
- Claim Field Investigative Services
- Solicitation number
- RFP-029-26-KM
- Issued by
- Leon County, Florida
About this file
This is a Non-Collusion Affidavit form required for the City of Tallahassee's Request for Proposals for Claim Field Investigative Services. The RFP seeks proposals from qualified firms to provide field investigative and adjusting services, including reporting and processing capabilities, either from a local office or through resident adjusters. The contract term is structured as a five-year base period, with the successful firm required to maintain sufficient resources and qualified staff to investigate liability claims for the City of Tallahassee. Detailed claims services requirements are specified in section 3.3 of the RFP documentation.
The Non-Collusion Affidavit must be completed and submitted by all respondents as a mandatory requirement for proposals to be considered complete and acceptable. The affidavit requires the respondent's authorized representative to swear under oath that the submission is genuine, that no collusion or conspiracy has occurred with other bidders regarding pricing or bid preparation, and that the quoted prices are fair and proper. The document must be notarized and signed by the respondent's authorized officer or representative, with the notary public's signature and commission expiration date required for the submission to meet compliance standards.
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Text version
NON-COLLUSION AFFIDAVIT OF RESPONDENT
State of , County of _, being first duly sworn, deposes and says that:
1) He/She is Respondent Integrator) that has submitted the attached RFP: of (Title) (Name of Corporation)
2) He/She is fully informed respecting the preparation and contents of the attached submittal and of all pertinent circumstances respecting such submittal.
3) Said IFB is genuine and is not a collusive or sham RFP.
4) Further, the said Respondent nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other Respondent, integrator or person to submit a collusive or sham RFP in connection with the Contract for which the attached RFP has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communications or conference with any other Respondent, integrator or person to fix the price or prices in the attached RFP or of any other Respondent, or to fix any overhead, profit or cost element of the RFP price or the RFP price of any other Respondent, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the City of Tallahassee or any person interested in the proposed Contract; and
5) The price or prices quoted in the attached bid are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the Respondent or any ·of its agents, representatives, owners, employees, or parties in interest, including this affiant.
(Signed)
(Title)
Subscribed and sworn to before me
This day of , 2025
Notary Public (Signature)
My Commission Expires:
THIS PAGE MUST BE SUBMITTED FOR RESPONSE TO BE CONSIDERED COMPLETE AND ACCEPTABLE.
NON-COLLUSION AFFIDAVIT OF RESPONDENT
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