Attachment_17-_Non_Collusion_Declaration.pdf
PDF 106 KB Posted
- Attached to
- RFP - 25SS0022 - Financial Governance
- Solicitation number
- 0000039397
- Issued by
- California
About this file
This is a Non-Collusion Declaration form required by the State of California Department of Veterans Affairs for Solicitation Number 25SS0022. The declaration serves as a certification document that bidders must execute to confirm the authenticity and independence of their bid submission. Bidders are required to attest that their bid is genuine, not collusive or sham, and has not been coordinated with any other bidder or undisclosed party. The form must be signed by an authorized company representative and executed under penalty of perjury, with the declaration requiring specification of the execution date and California city where the declaration is being made.
The Non-Collusion Declaration mandates that bidders certify they have not directly or indirectly induced other bidders to submit false bids, conspired with any party to submit sham bids or refrain from bidding, or engaged in any agreement to fix bid prices or cost elements. Bidders must also confirm that they have not disclosed their bid price, breakdown information, or related data to any corporation, partnership, or bid depository for collusive purposes, nor have they paid anyone to facilitate such activities. Any individual executing the declaration on behalf of a corporate entity, partnership, joint venture, limited liability company, or other business structure must represent that they possess full authority to execute the document on behalf of the bidder entity.
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Text version
State of California Solicitation Number: 25SS0022 Department of Veterans Affairs
NON-COLLUSION DECLARATION
The undersigned declares:
I am the of (Bidder), the party making the foregoing
(Title) (Name of Bidder) bid. The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The Bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The Bidder has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. The Bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the Bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements contained in the bid are true. The Bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
Any person executing this declaration on behalf of the Bidder, if the Bidder is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the Bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on , at , California.
(Date) (City)
Company Representative Signature
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