FORM 11-NON-COLLUSION CERTIFICATION.pdf
PDF 158 KB Posted
- Attached to
- MyFloridaNet-3 ITN
- Solicitation number
- ITN-16760
- Issued by
- Florida
About this file
This is a Non-Collusion Certification Form (Form 11) issued by the Florida Department of Management Services for ITN No. DMS-26/27-025 related to MyFloridaNetwork-3. The form serves as an affidavit requirement for all responding vendors and must be completed by an authorized representative of the bidding organization. The certification requires the signatory to confirm that pricing and proposal amounts have been developed independently without consultation, communication, or agreement with other providers or potential providers. No pricing information, approximate or otherwise, has been disclosed to competing firms prior to proposal opening.
The certification mandates that respondents attest they have not attempted to induce other firms to refrain from submitting responses, submit higher prices, or submit intentionally high or noncompetitive proposals. Respondents must also certify that their organization, including all affiliates, subsidiaries, officers, directors, and employees, are not currently under governmental investigation and have not been convicted or found liable in the past three years for any act involving conspiracy or collusion related to proposals on public contracts. The affidavit must be notarized and submitted with the proposal response, with false statements subject to prosecution as fraudulent concealment from the State of Florida.
View the file
Other files
Show all 29
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ITN No.: DMS-26/27-025 Page 1 of 2
NON-COLLUSION CERTIFICATION
4050 Esplanade Way Tallahassee, FL 32399-0950
850-488-2786
Ron DeSantis, Governor Tom Berger, Secretary
FORM 11 – NON-COLLUSION CERTIFICATION
FOR
MyFloridaNetwork-3
ITN NO: 26/27-025
THE STATE OF FLORIDA
DEPARTMENT OF MANAGEMENT SERVICES
ITN No.: DMS-26/27-025 Page 2 of 2
NON-COLLUSION CERTIFICATION
FORM 11 - NON-COLLUSION CERTIFICATION
STATE OF
COUNTY OF ______________
I state that I of , (Name and Title) (Name of Firm) am authorized to make this affidavit on behalf of my firm and its owner, directors and officers. I am the person responsible for the price(s) and amount(s) of this Response, and the preparation of this Response. I state that:
1. The price(s) and amount(s) of this Response have been arrived at independently and without consultation, communication or agreement with any other Provider, potential provider, Proposal, or potential Proposal.
2. Neither the price(s) nor the amount(s) of this Response, and neither the approximate price(s) nor approximate amount(s) of this Response, have been disclosed to any other f irm or person who is a Provider, potential Provider, Proposal, or potential Proposal, and they will not be disclosed before Proposal opening.
3. No attempt has been made or will be made to induce any f irm or persons to ref rain from submitting a
Response for this contract, or to submit a price(s) higher that the prices in this Response, or to submit any intentionally high or noncompetitive price(s) or other form of complementary Response.
4. The Response of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from, any firm or person to submit a complementary or other noncompetitive Response.
5. ______________ [name of responding organization], its af f iliates, subsidiaries, officers, director, and employees are not currently under investigation, by any governmental agency and have not in the last three years been convicted or found liable for any act prohibited by state or federal law in any jurisdiction, involving conspiracy or collusion with respect to Proposal, on any public contract, except as follows:
I state further that I and the named f irm understand and acknowledge that the above representations are material and important and will be relied on by the State of Florida. I understand and my firm understands that any misstatement in this affidavit is, and shall be treated as, fraudulent concealment from the State of Florida of the true facts relating to the submission of responses for this contract.
Dated this ____________day of ________________________, 2025.
Name of Respondent Organization:_______________________________________________
Signed by:________________________________________________ (signature)
Printed Name: ______________________________________________ being duly sworn deposes and says that the information herein is true and sufficiently complete so as not to be misleading.
Subscribed and sworn before me this __________ day of ___________________________________, 2025.
Notary Public: ____________________________________________ My Commission Expires:___________________________________
FORM 11 - NON-COLLUSION CERTIFICATION
File details come from the government source that posted it. Updated .