9-Attachment B-Bidders Cert.pdf
PDF 123 KB Posted
- Attached to
- PORT ORANGE FSED IRRIGATION
- Solicitation number
- PROJ-26-043
- Issued by
- Volusia County, Florida
About this file
This is a Bidder's Certification document for Halifax Health Medical Center related to Invitation to Bid (ITB) #PROJ-26-043 for the Port Orange Freestanding Emergency Department (PO FSED) irrigation system project in Florida. The certification form requires bidders to acknowledge receipt of complete bid papers and commit to abiding by all contained information and requirements. Bidders must certify compliance with federal, state, and local laws regarding equal opportunity employment practices, confirmation of adoption of a written sexual harassment policy in accordance with applicable regulations, and adherence to all federal, state, and local codes, rules, regulations, ordinances, and statutes.
The document includes a tax certification component wherein the bidder's executing officer must swear under oath that all statements are true and correct and made on behalf of the bidder with proper authorization. Additionally, the bidder must certify that it is not barred from contracting with any unit of local government in the State of Florida due to delinquency in payment of taxes administered by the Florida Department of Revenue, unless the bidder is actively contesting such tax liability or amount through established statutory procedures. The certification requires notarization and must be executed by an authorized company official with signature, date, and contact information provided.
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Text version
ATTACHMENT B
HALIFAX HEALTH MEDICAL CENTER
BIDDER’S CERTIFICATION
ITB # PROJ-26-043
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-26-043
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 , 2026.
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 , 2026.
Notary Public
(SEAL)
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