Affadavit_of_Non-Collusion.pdf
PDF 60 KB Posted
- Attached to
- Substance Abuse Treatment Services 2026
- Solicitation number
- 26-RFP-012
- Issued by
- Glades County, Brownsville CDP, Florida
About this file
This is an Affidavit of Non-Collusion document for the Flagler County Department of Health and Human Services' Substance Abuse Treatment Services 2026 contract opportunity in Florida. The affidavit requires the offeror to certify under oath that they are the sole party interested in the proposal, that no officer, employee, or agent of the Flagler County Board of County Commissioners or any competing offeror has any interest in the proposal, and that the proposal is being submitted with no past or present collusion with any other person, firm, or corporation. The document must be executed by an authorized representative of the offeror and notarized, with the notary public completing the acknowledgment section including date, identification verification, and commission information.
This affidavit is a standard compliance document required as part of the competitive procurement process for substance abuse and treatment services. Flagler County seeks proposals from local and regional non-profit organizations with experience in substance use prevention, substance abuse treatment, or related services, with minimum requests of $10,000 and maximum awards of $35,000. Funding is derived from the Alcohol and Drug Abuse Trust, generated from court fees under Florida Statutes Sections 938.13 and 893.165. The award is structured as a one-time funding grant with a potential one-year renewal contingent on fund availability. Agencies not currently funded by Flagler County Health and Human Services are eligible to apply.
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Text version
AFFIDAVIT OF NON-COLLUSION AND OF NON-INTEREST OF FLAGLER COUNTY EMPLOYEES
,* being first duly sworn, deposes and says that he (it) is the Offeror in the above proposal, that the only person or persons interested in said proposal are named therein; that no officer, employee or agent of the Flagler County Board of County Commissioners or of any other Offeror is interested in said proposal; and that affiant makes the above proposal with no past or present collusion with any other person, firm or corporation.
(Authorized Signature) (Date)
(Print Name)
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me on this day , 20 , by
, who is personally known to me or who has produced as identification.
Notary Public
My Commission Expires: Commission #
*NOTICE: State name of Offeror followed by name of authorized individual (and title) that is signing as Affiant. If Offeror is an individual, state name of Offeror only.
File details come from the government source that posted it. Updated .