Form_9.6_-_Anti-Collusion_Form.pdf
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- Solicitation number
- RFP-26-24-CW
- Issued by
- Volusia County, Florida
About this file
This is an Anti-Collusion Form required by the City of Port Orange, Florida for submission with a proposal in response to RFP 26-24-CW for the re-advertisement of elevation services for flood-prone homes. The solicitation encompasses an elevation project involving eleven single-family structures located in Florida. Respondents may propose to complete any number of structures ranging from one to all eleven properties, provided they can meet the required timeline for completion. No preference will be given to respondents bidding on all properties. The form must be completed and returned with the proposal submittal to be considered responsive.
By signing the Anti-Collusion Form, the respondent certifies that the proposal is submitted independently without any understanding, agreement, or connection with any other entity submitting a proposal for the same purpose, and that the proposal is fair and free from collusion or fraud. The form requires the authorized company officer or agent to provide a signature in ink along with printed name, title, firm name, address, telephone number, and Federal Employer Identification Number (FEIN). Unsigned proposals will be deemed incomplete and automatically disqualified and rejected. Execution and delivery of the signed proposal form constitutes acceptance of all specifications, contract terms, and conditions, and if awarded, the contract will be binding between the respondent and the City of Port Orange.
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Text version
FORM 9.6 – ANTI-COLLUSION FORM
ANTI-COLLUSION STATEMENT PROPOSAL FORM:
By signing this form, the Respondent agrees that this proposal is made without any other understanding, agreement or connection with any person, corporation or firm submitting a proposal for the same purpose and that the proposal is in all respects fair and without collusion or fraud.
SIGN in ink in the space provided below. Unsigned proposals will be considered incomplete and will be disqualified and rejected.
IT IS AGREED BY THE UNDERSIGNED RESPONDENT THAT THE SIGNING AND DELIVERY OF THE PROPOSAL REPRESENTS THE RESPONDENT’S ACCEPTANCE OF THE TERMS AND CONDITIONS OF THE FOREGOING SPECIFICATIONS, CONTRACT AND PROVISION, AND IF AWARDED, THIS CONTRACT WILL REPRESENT THE
AGREEMENT BETWEEN THE RESPONDENTS AND THE CITY OF PORT ORANGE.
NAME OF FIRM: ______________________________________________________________________________________________________________
SIGNED BY: ___________________________________________________________________________________________________________________
(MUST BE SIGNED BY A COMPANY OFFICER OR AUTHORIZED AGENT)
PRINTED SIGNATURE: ______________________________________________________________________________________________________
TITLE: ________________________________________________________________________________________________________________________
ADDRESS: ____________________________________________________________________________________________________________________
CITY, STATE AND ZIP CODE: ________________________________________________________________________________________________
TELEPHONE: __________________________________________________________
F.E.I.N.: _________________________________________________________________
This document must be completed and returned with your Submittal
File details come from the government source that posted it. Updated .