Attachment B Non-Collusion Affidavit Form.pdf
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- Solicitation number
- SFGOV-0000012013
- 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 Department of Public Health (DPH) Request for Proposals (SFGOV-0000012013) for HIV Hospice Care and Mental Health Services. The RFP was published on August 25, 2026, with a pre-proposal conference scheduled for September 9, 2026. The deadline for submitting questions is 5:00 PM PT on September 16, 2026, with an estimated Q&A addendum posting on September 23, 2026. Proposals are due by 2:00 PM PT on October 1, 2026. The estimated announcement of award is November 2026, followed by a Health Commission presentation in February 2027, with an estimated contract start date of March 1, 2027. The city seeks proposals from qualified and experienced firms to provide HIV Hospice Care and Mental Health Services, with the requirement that vendors must operate a licensed and currently functioning hospice care facility.
The Non-Collusion Affidavit form must be completed and submitted as part of Electronic File #2. The affidavit requires the proposer to affirm under oath that the proposal is genuine, non-collusive, and not a sham; that no collusion, conspiracy, or agreement exists with other proposers regarding pricing or submission; and that all statements within the proposal are truthful. The form requires the signature and title of an authorized representative of the proposing entity and includes specific language prohibiting price-fixing, disclosure of proposal contents to competitors, or payment of fees to facilitate collusive or sham proposals. All fields on the form are mandatory for submission.
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Text version
Attachment B Non-Collusion Affidavit
Request for Proposals SFGOV-0000012013 HIV Hospice Care and Mental Health 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 Click or tap here to enter text. of Click or tap here to enter text., 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 their 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: Click or tap here to enter text.
Title: Click or tap here to enter text.
A. Non-Collusion Affidavit
File details come from the government source that posted it. Updated .