Anti Noncollusion Affidavit.pdf

ATTACH NOTARIZED COPY TO BID IN BIDNET

City Clerk 1/10/2025 Page 1 of 2

ANTI/NON-COLLUSION AFFIDAVIT

The following Affidavit is submitted by the Bidder, or Bidder's Authorized Agent:

The undersigned of lawful age, being first duly sworn on oath, affirms and says:

1. The undersigned is the Bidder or the duly authorized agent of the Bidder submitting this competitive bid and as the lawful authority to execute this Affidavit and the attached Bid.

For the purpose of certifying the facts pertaining to the existence of collusion among bidders and between bidders and City or Trust officials or employees, as well as facts pertaining to the giving or offering of things of value to government personnel in return for special consideration in the letting of any contract pursuant to the Bid to which this statement is attached:

2. The undersigned is fully aware of the facts and circumstances surrounding the making of the Bid to which this statement is attached and has been personally and directly involved in the proceedings leading to the submission of such Bid; and

3. Neither the Bidder nor anyone subject to the Bidder's direction or control has been a party:

a. to any collusion among bidders in restraint of freedom of competition by agreement to bid at a fixed price or to refrain from bidding;

b. to any collusion with any City or Trust official, agent or employee as to quantity, quality or price in the prospective contract, or as to any other terms of such prospective contract; nor

c. in any discussion between bidders and any City or Trust official, agent or employee concerning exchange of money or other thing of value for special consideration in the letting of a contract.

4. The undersigned certifies, if awarded this contract, whether competitively bid or not, neither the Bidder nor anyone subject to Bidder’s direction or control has paid, given, or donated or agreed to pay, give or donate to any officer or employee of the City or Trust any money or other thing of value, either directly or indirectly, in procuring this contract.

This Bid will not be considered unless this form has been fully completed and signed and certified by the Bidder.

Certified this ____ day of ____________________________, 20____.

Name of Individual, Partnership, Limited Liability

Company, or Corporation herein called Bidder

Signature of Bidder or Bidder’s Authorized Agent

Type or print name and title of person who signed above

This Affidavit required for Public Improvement Projects by 61 Okla. Stat. Supp. 2008 § 115.

ATTACH NOTARIZED COPY TO BID IN BIDNET

City Clerk 1/10/2025 Page 2 of 2

ANTI/NON-COLLUSION AFFIDAVIT

N O T A R Y S T A T E M E N T

STATE OF ____________________________ )

COUNTY OF __________________________ )

I, _________________________________________, Notary Public in and for said County and

State, do hereby certify that on this _________ day of _________________________, 20 _____, _____________________________________, personally known to me to be the same person and official who executed the above and foregoing instrument as __________________________ appeared before me in person and acknowledged that, as such official, he/she executed the above instrument as his/her free and voluntary act on behalf of _________________________________ pursuant to authority conferred and for the uses and purposes therein set forth.

IN WITNESS THEREOF, I have hereunto set my hand and seal the day and year last above written.

Notary Public

My commission expires: My commission #:

(Seal)