Non Collusion Affidavit (17).pdf
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- Attached to
- Emergency Medical Services Billing
- Solicitation number
- PE-64800-NONST-2026-000000054
- Issued by
- Douglas County, Georgia
About this file
This document is a Non-Collusion Affidavit, a standard legal form used in public works bidding processes to ensure fair and ethical procurement practices. The affidavit requires the bidder or their representative to swear under oath that they have not engaged in any collusive practices, such as conspiring to manipulate bid prices, prevent competition, or receive improper financial benefits related to the bid.
The affidavit mandates that the signatory affirm, under penalty of perjury, that all information in the bid is true and correct. It includes spaces for the organization's name, the title of the person signing, their signature, and the specific bid number. The document also provides a formal acknowledgment section to be completed by a notary public, who will witness the signing and verify the identity of the person making the affirmation.
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Text version
NON-COLLUSION AFFIDAVIT
The undersigned bidder or agent, being duly sworn on oath, says that he/she has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to include anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding.
He/She further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee gift, commission or thing of value on account of such sale.
OATH AND AFFIRMATION
I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION CONTAINED
IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT.
Dated this ______________day of, ____, ____
(Name of Organization)
(Title of Person Signing)
(Signature)
(Bid Number)
ACKNOWLEDGEMENT
STATE OF_________________________ )
COUNTY OF_______________________ )
Before me, a Notary Public, personally appeared the above named and swore that the statements contained in the foregoing document are true and correct.
Subscribed and sworn to me this_______ day of ________________,_________.
Notary Public Signature My Commission Expires:___________________________________________________
File details come from the government source that posted it. Updated .