Attachment B Non-Collusion Affidavit Form.pdf
PDF 73 KB Posted
- Attached to
- DPH | HIV Prevention CBA Program Admin Services
- Solicitation number
- SFGOV-0000011811
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a Non-Collusion Affidavit Form for the City and County of San Francisco's Request for Proposals (SFGOV-0000011811) regarding HIV Prevention Capacity Building Assistance Program Administration Services. The affidavit must be completed and submitted with the technical and work proposal as Electronic File #1. The form requires the proposer to attest that the proposal is made independently, is genuine and not collusive or sham, and that the proposer has not induced, solicited, or colluded with any other proposer to submit false proposals or refrain from proposing.
The affidavit further requires the proposer to certify that no agreements have been made to fix proposal prices, overhead, profit, or cost elements; that all statements in the proposal are true; and that the proposer has not submitted pricing information, divulged proposal contents, or paid any fees to any entity to effectuate a collusive or sham proposal. The form requires the proposer's signature and title and must be completed as part of the proposal submission process.
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Text version
ATTACHMENT “B”
NON-COLLUSION AFFIDAVIT
REQUEST FOR PROPOSALS SFGOV-0000011811
HUMAN IMMUNODEFICIENCY VIRUS (HIV) PREVENTION CAPACITY BUILDING
ASSISTANCE PROGRAM ADMINISTRATION SERVICES
*THIS FORM MUST BE COMPLETED AND SUBMITTED WITH YOUR TECHNICAL/WORK
PROPOSAL (Electronic File #1)*
The undersigned, deposes and says that he or she is of , the party making the foregoing Proposal. That the Proposal is not made in the interests of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the
Proposal is genuine and not collusive or sham; that the Proposer has not directly or indirectly induced or solicited any other Proposer to put in a false or sham Proposal, and has not directly or indirectly colluded, conspired, connived, or agreed with any Proposer or anyone else to put in a sham Proposal, or that anyone shall refrain from Proposing; that 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 of anyone interested in the proposed contract; that all statements contained in the Proposal are true; and, further, that the Proposer has not, directly or indirectly, submitted his or her Proposal price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereof, 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.
Signature: ______________________________________________
Title: _____________________________________________
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File details come from the government source that posted it. Updated .