COH Non Collusion Affidavit_2025.pdf.pdf

CITY OF HARRISBURG

NON-COLLUSION AFFIDAVIT

Instructions

The following information is to provide (at minimum) an overall explanation of non-collusion and the role/responsibility of entities desiring to participate in the bidding process for pending projects as advertised.

• A Non-Collusion Affidavit must be executed by the person responsible (i.e; owner, employee, officer) for making decisions on price(s) and amount(s) quoted in the bid.

• Bid rigging and other efforts to restrain competition, and making false sworn statements in connection with the submission of bids are unlawful and may be subject to criminal prosecution.

• The person who signs the affidavit should be aware of all bidding requirements and protocol. By signing this document, she or he must be assured that each statement is true and accurate, making diligent inquiry, as necessary, of all other persons employed by or associated with the bidder as to their responsibilities for the preparation, approval and/or submission of the bid.

• In the case of a bid submitted by a joint venture, each party to the venture must be identified in the bid proposal, and an affidavit be submitted separately on behalf of each party.

• The term “complementary bid” as used in the affidavit, incorporates the meaning commonly associated with its’ use in the bidding process. This includes the knowing submission of bid amounts higher than the bid from another Contractor, any intentionally high or noncompetitive bid, and any other form of bid submitted for the purpose of giving a false appearance of competition.

• Failure to submit an affidavit with the bid proposal in compliance with these instructions may result in disqualification of the bid.

CITY OF HARRISBURG

NON-COLLUSION AFFIDAVIT

Project Name: _____________________________

This Non-Collusion Affidavit is material to any contract/purchase order awarded pursuant to this bid. According to Section 4507 of Act 57 of May 15, 1998, 62 Pa. C.S. § 4507, governmental agencies may require Non-Collusion Affidavits to be submitted with any bids.

I, _______________________(Name), state that I am the ________________(Title) of ____________________________(Entity Name), hereinafter referred to as “Entity”, and that I am authorized to make this affidavit on behalf of said Entity, and its owners, directors, and officers. I am the person responsible in Entity for the price(s) and amounts in this bid. By submittal of a bid for the above referenced project and execution of this affidavit, the following statements are acknowledged:

1. The price(s) and amount of bid have been arrived at independently and without consultation, communication or agreement with any other contractor, potential contractor or bidder.

2. Neither the price(s), amount of this bid nor the approximate price(s) or amount of bid, have been disclosed to any other company or person who may be a contractor or potential contractor, nor will they be disclosed prior to this bid opening.

3. No attempt has been made, or will be made, to induce any company or person to refrain from bidding on this contract or submit a proposal higher than this bid, or to submit any intentionally high or noncompetitive bid or other form of complementary bid.

4. This bid is made in good faith and not pursuant to any agreement or discussion with, or inducement from any company or person to submit a complementary or other noncompetitive bid.

5. To my best knowledge, the Entity, its affiliates, subsidiaries, officers, directors and employees are not currently under investigation by any governmental agency and have not in the last three years been convicted or found liable for any act prohibited by State or Federal law in any jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract. A statement of conviction or liability does not prohibit the City of Harrisburg from accepting the bid or awarding the contract, but may be grounds for the City of Harrisburg to decline an award of contract on the basis of lack of responsibility.

6. The Entity is not currently under suspension or review by the City of Harrisburg, or any other Federal, State or Local Governmental entity. If certification cannot be made, a written explanation to support the inability of providing such shall be submitted with this bid.

Signature Date

COMMONWEALTH OF PENNSYLVANIA :

: SS:

COUNTY OF __________________ :

On this, the _____ day of ________________ 2025, before me, a Notary Public, the undersigned officer, personally appeared _____________________________________(Name), who acknowledged himself/herself to be the _____________________(Title) of _____________________________(Entity Name), and that he/she, as such officer, and being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the by himself/herself as such officer.

IN WITNESS WHEREOF, I have hereunto set my hand and official seal.

__________________________________ (Seal)

My commission expires: Notary Public