Attachment D - Non Collusion Affidavit.pdf
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- Solicitation number
- RFP-116165
- Issued by
- Clarke County, Virginia
About this file
This is a Non-Collusion Affidavit attachment to RFP #2026-FA01 issued by Culpeper County, Virginia, for forensic financial review and auditing services. The affidavit is a mandatory certification document that must be submitted by all proposal respondents and affirms under oath that the offeror's proposal is genuine, independently developed, and free from collusive practices. The form requires the authorized representative of the responding firm to declare that no coordination, price-fixing, or anticompetitive agreements have occurred with competing bidders, and that no improper payments or inducements have been offered to county officials or employees. Proposals are due April 2, 2026, at 2:00 p.m. EDT, with an anticipated Board award decision on May 6, 2026. The engagement will be a single, one-time engagement with services commencing immediately upon contract execution and substantially completed within 120 calendar days.
The affidavit must be notarized and submitted with the proposal. Violations of the non-collusion requirements constitute violations of the Virginia Governmental Frauds Act, the Virginia Public Procurement Act, and federal antitrust law, and can result in substantial fines, imprisonment, and civil damages. The affidavit requires signature, printed name, title, date, and notary certification, and serves as a legal document binding the offeror to the truthfulness of all representations made in the proposal submission. No specific pricing information, set-asides, or incumbent vendor details are contained within this attachment; these elements are addressed in other RFP documentation.
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ATTACHMENT D FORENSIC FINANCIAL REVIEW AND AUDITING SERVICES RFP #2026-FA01
Attachment D — RFP #2026-FA01 — Culpeper County, Virginia
ATTACHMENT D
Non-Collusion Affidavit
Culpeper County, Virginia
Virginia Code § 2.2-4374
COMMONWEALTH OF VIRGINIA
COUNTY/CITY OF ________________________________________
I, the undersigned, being first duly sworn, depose and state that:
1. I am the _____________________________ (title) of _____________________________ (firm name), the offeror that has submitted the attached proposal in response to RFP #2026-FA01 issued by Culpeper County, Virginia.
2. I am authorized to make this affidavit on behalf of the offeror, its officers, directors, partners, and employees.
3. The proposal submitted in response to RFP #2026-FA01 is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation.
4. The proposal is genuine and not collusive or sham.
5. The offeror has not directly or indirectly induced or solicited any other offeror to put in a false or sham proposal, and has not directly or indirectly colluded, conspired, connived, or agreed with any offeror or anyone else to put in a sham proposal, or to refrain from submitting a proposal in response to this solicitation.
6. The offeror has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the proposal price or any element thereof, or to fix any overhead, profit, or cost element of the proposal price, or to secure any advantage against Culpeper County or any person interested in the proposed contract.
7. All statements contained in the proposal and in this affidavit are true.
ATTACHMENT D FORENSIC FINANCIAL REVIEW AND AUDITING SERVICES RFP #2026-FA01
Attachment D — RFP #2026-FA01 — Culpeper County, Virginia
8. The offeror has not, directly or indirectly, submitted its proposal price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to any individual or group of individuals, or to effectuate a collusive or sham proposal.
9. The offeror has not paid, given, or donated or agreed to pay, give, or donate to any officer or employee of Culpeper County, or to any other person, any money or other thing of value, either directly or indirectly, in procuring the contract to which this proposal relates.
NOTICE: Collusive bidding is a violation of the Virginia Governmental Frauds Act (Virginia Code § 18.2-
498.1 et seq.), the Virginia Public Procurement Act (Virginia Code § 2.2-4374), and federal antitrust law, and can result in fines, prison sentences, and civil damage awards. Pursuant to § 4-106 of the Culpeper County Purchasing Resolution, any or all bids or proposals may be rejected if reasonable grounds exist for believing that collusion exists among any bidders or offerors.
Firm Name: ________________________________________________________________________
Signature:
Printed Name:
Title:
Date:
NOTARIZATION
Subscribed and sworn to before me this ______ day of __________________, 20____.
Notary Public: _______________________________________________________________________
My Commission Expires: ______________________________________________________________
Registration Number: _________________________________________________________________
[NOTARY SEAL]
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