EXHIBIT_“C”_-_Non_Collusion_Affidavit.pdf
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- Solicitation number
- 26-003
- Issued by
- Broward County, Florida
About this file
This is a Non-Collusion Affidavit form, a standard contract compliance document used by state and local government agencies including Charles County, Maryland; the City of Hayward, California; Santa Rosa County, Florida; and the City of Broward, Florida, in their procurement processes. The affidavit requires proposers to certify under oath that they have not divulged, discussed, compared, or colluded with any other proposer regarding their response to the Request for Proposals. The form must be signed by an authorized representative of the proposing entity and notarized by a qualified notary public before submission. The affidavit serves as a legal instrument affirming the proposer's compliance with anti-collusion requirements and must be completed with the proposer's name, title, organization details, date of execution, and the notary's seal and signature.
The Non-Collusion Affidavit is a mandatory submission requirement across multiple procurement opportunities, including the Pinefield Fire & EMS Station construction project in Charles County (responses due September 11, 2025), the City of Hayward's Shaded Structure design and construction project (responses due August 15, 2025), Santa Rosa County's Property Abatement project (responses due October 21, 2025), and the Broward County Historic M.C. Frost House architectural services project. Proposers must complete this form in addition to other required documentation such as experience forms, compliance plans, and bid bonds. The affidavit protects the integrity of the competitive bidding process and ensures that awards are made based on fair competition rather than collusive practices between competing vendors.
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Text version
EXHIBIT “C”
NON-COLLUSION AFFIDAVIT
The undersigned Proposer has not divulged, discussed or compared his/her/its Response with any other Proposer, and has not colluded with any other Proposer or party to this Request for Proposals whatsoever.
Signature of Proposer
PRINT Name of Proposer
Title
, 2024 Date
STATE OF
COUNTY OF ___________________
BEFORE ME, an officer duly authorized by law to administer oaths and take acknowledgments, personally appeared ☐ physical presence or ☐ online notarization, on _________________ as _________________, of ___________________, an organization authorized to do business in the State of Florida, and acknowledged and executed the foregoing statement as the proper official of _______________________ for the use and purposes mentioned in it and affixed the official seal of the entity, and that the instrument is the act and deed of that entity. He/she is personally known to me or has produced __________________________ as identification.
IN WITNESS OF THE FOREGOING, I have set my hand and official seal at in the State and County aforesaid on this _____ day of _________________, 2024.
Notary Seal ___________________________________ Signature of Notary Public
Printed Name of Notary Public
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