District Certifications Form.pdf
PDF 77 KB Posted
- Solicitation number
- PE-55267-NONST-2026-000000038
- Issued by
- Jefferson County, Georgia
About this file
This is a District Certification Form required by the State of Georgia for bid submission. The form serves as a legal attestation in which bidders certify that their proposal is submitted independently and without any prior understanding, agreement, or collusive arrangement with other bidding entities for the same materials, supplies, or equipment. Bidders must affirm that their submission is fair and free from fraud, and they acknowledge understanding that collusive bidding violates both State and Federal law and carries penalties including fines, imprisonment, and civil damages under O.C.G.A. 50-5-67.
The form requires an authorized representative of the bidding organization to sign and date the certification, print their name, and confirm they are authorized to execute the bid on behalf of the bidder. Additionally, bidders must certify compliance with O.C.G.A. 45-10-20 et seq., representing that the relevant statutory provisions have not been and will not be violated in any respect related to the bid submission.
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Text version
District Certification Form:
Collusion:
“ I certify that this proposal is made without prior understanding, agreement or connection with any corporation, firm or person submitting a bid for the same materials, supplies, or equipment, and is in all respect fair and without collusion or fraud. I understand that collusive bidding is a violation of State and
Federal law and can result in fines, prison sentences, and civil damage awards. I agree to abide by all conditions of this bid and certify that I am authorized to sign this bid for the bidder. (O.C.G. A 50-5-67). I further certify that the provisions of the official code of Georgia annotated 45-10-20 et seq. have not and will not be violated in any respect.”
Authorized Signature Date
Print Name
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