ESBD_393954_1738699328351_Attachment D - Affidavit.pdf
PDF 8 KB Posted
- Attached to
- Comprehensive Master Plan
- Solicitation number
- ARC1001
- Issued by
- Anderson County, Texas
About this file
This is an Affidavit form (Attachment D) required for bidders submitting proposals to West Texas Centers for MHMR in Anderson County, Texas. The affidavit must be completed by the manager, secretary, or other authorized agent of the bidding organization and notarized before submission. The document explicitly states that bids submitted without this completed affidavit will not be considered.
The affidavit requires bidders to certify two key declarations: 1) that they have full knowledge of relations with other firms in the same line of business and are not participating in any trust, pool, or combination to control prices or influence bidding behavior, and 2) that they have not given, offered, or intend to give any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to public servants in connection with the bid. The document must include the bidder's name, authorized signature and title, complete address with zip code, telephone number, and date, along with notarization in the specified Texas county.
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Text version
Attachment D
AFFIDAVIT
BEFORE ME, the undersigned authority, on this day personally appeared __________________________________________ known to me to be the person whose name is subscribed to the following, who upon oath, says:
I AM THE Manager, Secretary or other agent or officer or the principal of the Bidder in the matter of the bids to which this affidavit is attached, and I have full knowledge of the relations of the Bidder with the other firms in this same line of business, and the Bidder is not a member of any trust, pool, or combination to control the price of supplies bid on, or to influence any person to bid or not bid thereon.
I further affirm that the Bidder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted bid.
Affiant
SWORN TO AND SUBSCRIBED BEFORE ME by the above Affiant, who, on oath states that the facts contained in the above are true and correct this _______________________day of __________________, 20___.
Notary Public in and for
__________________________________ County, Texas
Name of Bidder: ______________________________________________
Signed by: ______________________________________________
(Sign Name in Writing) (Title)
Address: ______________________________________________ (Zip Code)
Telephone Number: ______________________________________________
(Date)
NOTE: BIDS NOT ACCOMPANIED BY THIS AFFIDAVIT WILL NOT BE
CONSIDERED.
File details come from the government source that posted it. Updated .