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 required for submission with proposals to state and local contract opportunities in Florida. The document is applicable to multiple jurisdictions including Charles County, Maryland; Santa Rosa County, Florida; the City of Hayward, California; and the City of Broward, Florida, across several distinct procurement opportunities.
The affidavit requires the proposing entity to certify under oath that it has not divulged, discussed, or compared its response with any other proposer and has not colluded with any other proposer or party to the Request for Proposals. The document must be executed before a notary public authorized to administer oaths and take acknowledgments, with the notary verifying the proposer's identity through either personal knowledge or acceptable identification. The form includes designated spaces for the proposer's signature and printed name, title, date, and the notary's signature, printed name, official seal, and date. Completion is required in the state and county where the notary is located, with the affidavit dated in 2024. This certification serves as a compliance mechanism to prevent bid-rigging and ensure fair competition across all applicable procurement opportunities, including the Pinefield Fire & EMS Station construction project in Maryland, the Abatement of Properties project in Santa Rosa County, Florida, the shaded structure design and installation project in Hayward, California, and the historic restoration services for the M.C. Frost House in Broward County, Florida.
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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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