9-Attachment B-Bidders Cert.pdf
PDF 123 KB Posted
- Attached to
- PORT ORANGE FSED IRRIGATION
- Solicitation number
- PROJ-26-043 - re-bid
- Issued by
- Volusia County, Florida
About this file
This is a Bidder's Certification form for Halifax Health Medical Center related to Invitation to Bid (ITB) #PROJ-26-043 for the Port Orange Freestanding Emergency Department (PO FSED) irrigation project in Florida. The project involves furnishing and installing a complete irrigation system for approximately two acres of land adjacent to the Port Orange FSED facility. The certification document establishes baseline requirements that all bidders must acknowledge and confirm prior to bid submission.
Bidders submitting proposals must certify compliance with multiple conditions, including receipt of a complete set of bid papers, adherence to all federal, state, and local laws regarding equal opportunity employment, implementation of a written sexual harassment policy compliant with applicable regulations, and confirmation that they have not engaged in collusion or unethical practices with any District personnel. Additionally, bidders must certify under oath that they are not barred from contracting with any unit of local government in Florida due to tax delinquency with the Florida Department of Revenue, unless such delinquency is being actively contested through appropriate statutory procedures. The form requires signature and notarization from an authorized company official, establishing the bidder's legal acknowledgment of these certifications.
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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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