Attachment B Non-Collusion Affidavit Form.pdf
PDF 1 MB Posted
- Attached to
- DPH | PEI Doula Midwifery Prenatal Care Models
- Solicitation number
- SFGOV-0000012083
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a Non-Collusion Affidavit form for the Department of Public Health (DPH) Request for Proposals (SFGOV-0000012083) titled "PEI Community-Based Doula Midwifery Prenatal Care Models" issued by the City and County of San Francisco, California. The RFP was published on October 26, 2026, with a pre-proposal conference scheduled for November 4, 2026, at 9:00 AM PT via Microsoft Teams. The deadline for submitting questions is November 12, 2026, at 5:00 PM PT, with an estimated Q&A addendum posting on November 20, 2026. Proposals are due on December 7, 2026, at 2:00 PM PT. Short-listing notifications for interviews are estimated for January 2027, with interviews and award announcements also expected in January 2027. The Health Commission presentation is anticipated for February 2027, and the estimated contract start date is July 1, 2027.
The Non-Collusion Affidavit requires the duly authorized representative of the proposing company to affirm that the proposal is genuine and not collusive or sham, that no inducements or solicitations have been made to other proposers, and that no agreements exist to fix pricing, overhead, profit, or cost elements. The affidavit certifies that all statements in the proposal are true and that no fees have been paid or will be paid to any entity to effectuate a collusive or sham proposal. The form requires completion of all fields including the legal company name, authorized representative's printed name and title, date, and authorized representative's signature, and must be included with Electronic File #2 of the submission.
View the file
Other files
Show all 12
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
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:
| Attachment B |
| Non-Collusion Affidavit |
| A. Non-Collusion Affidavit |
| B: Sourcing ID: Request for Proposals SFGOV-0000012083 |
| B: Solicitation Title: PEI Community-Based Doula Midwifery Prenatal Care Models |
| B: Legal Name of Company Proposer: |
| B: Authorized Representatives Printed Name: |
| B: Authorized Representatives Title: |
| B: Date: |
File details come from the government source that posted it. Updated .