Attachment B Non-Collusion Affidavit Form.docx
DOCX document 28 KB Posted
- Attached to
- DPH | Food and Nutrition Services for HIV
- Solicitation number
- SFGOV-0000012011
- Issued by
- San Francisco County, California
About this file
This is a Non-Collusion Affidavit form required for submission with a Request for Proposals (RFP) issued by the San Francisco Department of Public Health (DPH) for Food and Nutrition Services for People Living with HIV. The RFP seeks qualified firms to provide food and nutrition services to low-income HIV-positive individuals in San Francisco. The procurement timeline includes a pre-proposal conference scheduled for September 10, 2026, at 2:00 PM PT via Microsoft Teams, a question deadline of September 17, 2026, and a proposal submission deadline of October 5, 2026, at 2:00 PM PT. Short-listing notifications, interviews, and award announcements are estimated for November 2026, with an anticipated contract start date of April 1, 2027. All fields in the affidavit form must be completed and submitted as part of Electronic File #2 of the proposal package.
The Non-Collusion Affidavit requires the authorized representative of the proposing entity to certify that the proposal is genuine and not collusive, that no collusion or price-fixing has occurred with other proposers, and that all statements contained in the proposal are truthful. The affidavit specifically mandates that proposers have not solicited false or sham proposals from competitors, conspired to fix proposal prices or cost elements, sought unfair advantages against the public body, or shared proposal information with any third parties. The form requires the legal name of the company, the authorized representative's printed name and title, the date, and the authorized representative's signature.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment F MCO Declaration Form.pdf | ||
| Attachment C Reference Form.docx | DOCX document | |
| Attachment D 12L Compliance.docx | DOCX document | |
| Attachment M City's Contract Terms P-600 for Professional Services.pdf | ||
| Attachment E CMD LBE Form 2A_Professional Services.pdf | ||
| DPH___Food_and_Nutrition_Services_for_HIV.xml | XML file | |
| Attachment H First Source.docx | DOCX document | |
| SFGOV-0000012011_RFP_Food_and_Nutrition_Services_for_PLWH.pdf | ||
| Attachment I Cost Proposal Form_NonBHS.xlsx | XLSX spreadsheet | |
| DPH___Food_and_Nutrition_Services_for_HIV.pdf | ||
| Attachment A Contact Information Cover Sheet.docx | DOCX document | |
| Attachment G HCAO Declaration Form.pdf |
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Text version
Attachment B Non-Collusion Affidavit Request for Proposals SFGOV-0000012011 Food and Nutrition Services for People Living with HIV All fields are required. This form must be completed and included with Electronic File #2.
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): Click or tap here to enter text.
Authorized Representative’s Printed Name: Click or tap here to enter text.
Authorized Representative’s Title: Click or tap here to enter text.
Date: Click or tap here to enter text.
Authorized Representative’s Signature:
File details come from the government source that posted it. Updated .