District Certifications Form.pdf

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Attached to
Internet Circuit
Solicitation number
PE-55267-NONST-2026-000000033
Issued by
Jefferson County, Georgia

About this file

This is a District Certification Form required by the State of Georgia for bid submissions. The form constitutes a collusion certification statement in which bidders attest that their proposal is submitted independently without prior understanding, agreement, or connection with any other corporation, firm, or person submitting a competing bid for the same materials, supplies, or equipment. Bidders certify that their submission is fair and free from collusion or fraud, and acknowledge their understanding that collusive bidding violates State and Federal law and can result in criminal penalties including fines and imprisonment as well as civil damage awards. The form requires the authorized representative of the bidding entity to sign and date the certification, print their name, and affirm compliance with all bid conditions and their authority to execute the bid on behalf of the bidder.

The certification also requires bidders to affirm that the provisions of the Official Code of Georgia Annotated (O.C.G.A.) 45-10-20 et seq. have not been and will not be violated in any respect. This standard form is mandatory for all bid submissions and serves as a legal attestation of the bidder's integrity and compliance with applicable Georgia statutes governing procurement practices.

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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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