HC_EMAILAI_NONCOLLUSION_AFFIDAVIT2.pdf
PDF 35 KB Posted
- Attached to
- 4618-20261013152929 Hattiesburg
- Solicitation number
- 3170036837
- Issued by
- Greene County, Mississippi
About this file
This is a Non-Collusion Affidavit for Hattiesburg Clinic RFP No. HC-RTG-2026-EMAIL, an AI-Driven Email & Web-Browser Threat Detection solution for Microsoft 365. The affidavit is a required attachment (Attachment A) to the proposal submission and must be completed and notarized by an authorized representative of the bidding company. The document does not specify project quantities, response dates, due dates, site visits, bidder conferences, award dates, or contract terms and renewal options, as it serves solely as a certification form rather than a statement of work or solicitation overview document.
The affidavit requires the affiant to certify that the proposal is genuine and free from collusion, that pricing was developed independently without consultation with competitors, that no gratuities or financial inducements have been offered to Hattiesburg Clinic personnel or evaluation committee members, and that the bidder and its principals are not debarred or suspended from federal transactions under 2 CFR Part 180. The document does not address pricing terms, set-asides, incumbents, current environment, funding sources, or contract amounts, as these substantive elements would be contained in separate RFP documentation.
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Other files
| File | Type | Posted |
|---|---|---|
| 4618-20261013152929 HATTIESBURG CLINIC.pdf | ||
| HC_EMAILAI_ATTACHMENT_B_PRICING_FORM3.pdf |
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Text version
Hattiesburg Clinic RFP No. [HC-RTG-2026-EMAIL] — Attachment A
Attachment A Non-Collusion Affidavit
Hattiesburg Clinic RFP No. [HC-RTG-2026-EMAIL] — AI-Driven Email & Web-Browser Threat Detection for Microsoft 365
STATE OF ______________________________
COUNTY OF ____________________________
I, _________________________________________ (name of affiant), being first duly sworn, depose and state that:
1. I am the _______________________________ (title) of _________________________________________________ (legal name of company), the bidder that has submitted the attached proposal, and I am fully authorized to make this affidavit on behalf of the bidder.
2. I am fully informed with respect to the preparation and contents of the attached proposal and of all pertinent circumstances respecting it.
3. The proposal is genuine and is not a collusive or sham proposal.
4. Neither the bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly, with any other bidder, firm or person to submit a collusive or sham proposal in connection with this solicitation, or to refrain from submitting a proposal.
5. The prices in the proposal have been arrived at independently, without consultation, communication or agreement with any other bidder or competitor for the purpose of restricting competition, and have not been knowingly disclosed to any other bidder or competitor before the proposal opening.
6. No attempt has been made or will be made by the bidder to induce any other person or firm to submit or not to submit a proposal for the purpose of restricting competition.
7. No officer, employee, or agent of Hattiesburg Clinic, P.A., and no member of the Clinic’s evaluation committee, has any financial interest in the bidder or in this proposal, and the bidder has not offered or given any gratuity, favor, or anything of monetary value to any such person in connection with this solicitation.
8. The bidder, and its principals, are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in transactions funded by the federal government (2 CFR Part 180).
9. The statements in this affidavit are true and correct, and I understand that any false statement may result in rejection of the proposal, termination of any resulting contract, and other remedies available at law.
Hattiesburg Clinic RFP No. [HC-RTG-2026-EMAIL] — Attachment A
BIDDER / AFFIANT
Field Entry
Signature of affiant
Printed name
Title
Company (legal name)
Address
UEI (SAM.gov)
Date
NOTARY
Subscribed and sworn to before me this ______ day of ____________________, 20____.
Notary Public signature
Printed name
My commission expires: ______________________
(SEAL)
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