Attachment B Non-Collusion Affidavit Form_1.pdf
PDF 108 KB Posted
- Attached to
- DPH | As-Needed Radiation Safety Consulting Svc
- Solicitation number
- SFGOV-0000011986
- Issued by
- California
About this file
This is a Non-Collusion Affidavit form for the Department of Public Health (DPH) in California, issued as part of Request for Proposals SFGOV-0000011986 for As-Needed Radiation Safety Consulting Services. The RFP seeks experienced firms to provide qualified staff to serve as a Radiation Safety Officer supporting safe and compliant use of ionizing radiation, including regulatory compliance activities, nuclear medicine program development, audits, personnel dosimetry oversight, training, documentation management, and consultation during regulatory inspections. The RFP was published on September 11, 2026, with a deadline for questions on September 29, 2026, and a question and answer addendum expected to post on October 6, 2026. The proposal submission deadline is 2:00 PM PT on October 14, 2026, with an estimated award announcement on November 13, 2026 and an estimated contract start date of March 1, 2027. A pre-proposal conference is scheduled for September 22, 2026 at 11:00 AM PT via Microsoft Teams.
The Non-Collusion Affidavit must be completed and submitted with Electronic File #2 as a required document. All fields on the form must be completed, including the legal name of the company, authorized representative's printed name and title, date, and authorized representative's signature. The affidavit requires the authorized representative to attest that the proposal is genuine and not collusive or sham, that no collusion or coordination has occurred with other proposers, that no fees have been paid to facilitate collusion, and that all statements in the proposal are true.
View the file
Other files
Show all 23
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Attachment B
Non-Collusion Affidavit
Request for Proposals SFGOV-0000011986
As-Needed Radiation Safety Consulting Services
All fields are required. This form must be completed and included with Electronic File #2.
A. Non-Collusion Affidavit
The undersigned deposes and says that they are a duly authorized representative of the party making the foregoing Proposal. The Proposal is not made in the interests of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The Proposal is genuine and not collusive or sham. The Proposer has not directly or indirectly induced or solicited any other Proposer to submit a false or sham Proposal, and has not directly or indirectly colluded, conspired, connived, or agreed with any Proposer or anyone else to submit a sham Proposal, or to have anyone refrain from proposing. The Proposer has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the Proposal price of the Proposer or any other Proposer, or to fix any overhead, profit, or cost element of the Proposal price, or of that of any other Proposer, or to secure any advantage against the public body awarding the contract or anyone interested in the proposed contract. All statements contained in the Proposal are true. The Proposer has not, directly or indirectly, submitted its Proposal price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company, association, organization, Proposal depository, or any other member or agent thereof to effectuate a collusive or sham Proposal.
Legal Name of Company (Proposer):
Authorized Representative’s Printed Name:
Authorized Representative’s Title:
Date:
Authorized Representative’s Signature:
| Text1: |
| Text2: |
| Text3: |
| Text4: |
| Text5: |
File details come from the government source that posted it. Updated .