9-NONCOLLUSION AFFIDAVIT.pdf
PDF 105 KB Posted
- Attached to
- Staff Evaluation and Compliance Training Module
- Solicitation number
- RFP 27-14-31
- Issued by
- Maricopa County, Tucson City, Arizona
About this file
This is a Non-Collusion Affidavit form required by the Tolleson Union High School District #214 in Arizona for the Staff Evaluation and Compliance Training Module procurement. The affidavit must be completed and notarized by the person executing the bid on behalf of the bidding contractor, firm, or corporation. The document requires the affiant to certify under oath that the submitted bid is genuine and not collusive, that no sham bids or anti-competitive inducements have been made, and that no collusion has been undertaken to secure competitive advantage over other bidders. The affidavit must include the affiant's name, title, and the contractor or bidder's name, and must be signed before a notary public.
The affidavit further requires the bidder to confirm compliance with Arizona Revised Statutes § 15-213(O) and Arizona Administrative Code R7-2-1024(B.1.q) and R7-2-1003(J) by certifying that no personal gifts or benefits have been offered, conferred, or agreed to be conferred on any person supervising or participating in contract administration, financial transactions, or the planning, recommending, selection, or contracting processes for materials, services, goods, or construction related to the District. This form is mandatory and must be notarized prior to bid submission.
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Text version
NON-COLLUSION AFFIDAVIT
State of ____________________ )
) ss.
County of __________________ )
Before me, the undersigned, personally appeared
_____________________________________________________________________________ , affiant, (Name) the ____________________________________________________________________________________
(Title)
(Contractor/Bidder) the persons, corporation, or company who makes the accompanying Bid, having first been duly sworn, deposes and says:
That such Bid is genuine and not sham or collusive, nor made in the interest of, or behalf of, any persons not herein named, and that the Bidder has not directly or indirectly induced or solicited any other Bidder to put in a sham Bid, or any other person, firm or corporation to refrain from submitting a Bid, and that the Bidder has not in any manner sought by collusion to secure for itself an advantage over any other Bidder, and
That Bidder has taken steps and exercised due diligence to ensure that Bidder has not offered, conferred, or agreed to confer any personal gift or benefit on a person who supervises or participates in contracts, purchases, payments, claims or other financial transactions, or on a person who supervises or participates in planning, recommending, selecting or contracting for materials, services, goods, construction or construction services of the District, in accordance with A.R.S. § 15-213(O), A.A.C. R7-
2-1024 (B.1.q), and A.A.C. R7-2-1003(J).
(Signature of Affiant)
(Title)
Subscribed and sworn to before me this ___________ day of _______________________________ , 20 _____________
Signature of Notary Public in and for the
State of ________________________________________________
County of _______________________________________________
THIS FORM MUST BE NOTARIZED
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