Non_Collusion_Affidavit.cleaned.pdf
PDF 74 KB Posted
- Attached to
- Lompoc Library HVAC Units Replacement Project
- Solicitation number
- RFP NO. 3077
- Issued by
- Santa Barbara County, Los Angeles City, California
About this file
This is a Non-Collusion Affidavit form issued by the City of Lompoc Purchasing Department for the Lompoc Library HVAC Units Replacement Project. The affidavit must be completed and signed by an authorized representative of bidding companies submitting proposals for this project. Bids are due by 2:00 pm on Friday, September 4, 2026, and all proposals must remain valid for 90 calendar days following the bid opening date. Interested parties must register as "Registered Bidders" by returning the Registered Bidder Information Sheet to avoid potential disqualification. All communications regarding the solicitation must be directed to the Purchasing Officer or designated staff; bidders are prohibited from communicating with other City staff members about their bids. Questions regarding the project must be submitted in writing to Theresa Hernandez, Senior Buyer, by 4:00 pm on August 27, 2026. Proposals must be submitted in person to the Purchasing Office with original signatures and figures; proposals received by telephone, email, or fax will not be accepted, and late submissions will be returned unopened.
The Non-Collusion Affidavit requires the bidder to certify under penalty of perjury that the bid is genuine and not collusive, that no agreements have been made with other bidders to submit sham bids or refrain from bidding, and that no consideration has been exchanged for collusion or restraint of competition. The affidavit further requires the bidder to confirm that its bid price and terms have not been disclosed to any other bidder or potential bidder prior to the official bid opening. The form must be notarized if required and signed by an authorized company representative with their title, printed name, and date clearly indicated.
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Text version
Non-Collusion Affidavit
City of Lompoc, Purchasing Department, 100 Civic Center Plaza, Lompoc, CA 93436 (805)875-8000 fax (805)875-8633 purchasing@ci.lompoc.ca.us
To: City of Lompoc – Purchasing Department
From:
Project Name: __________________________________________
Solicitation Number: _____________________________________
Bidder/Company Name: ___________________________________
Business Address: _______________________________________
City, State, ZIP: _________________________________________
AFFIDAVIT
I, ______________________________________, (Name of authorized representative) being duly sworn, depose and say that:
1. I am the ____________________________ of the above-named company, (Title or Position) and am authorized to make this affidavit on its behalf.
2. The bid submitted for the above-referenced project is genuine and not a sham or collusive.
3. Neither the bidder nor any of its officers, partners, owners, agents, representatives, employees, or parties in interest has colluded, conspired, or agreed—directly or indirectly—with any other bidder, firm, or person to submit a sham bid or to refrain from bidding.
4. No person or entity has received or will receive any fee, commission, gift, or other consideration in exchange for collusion or restraint of competition.
5. The bidder has not disclosed its bid price or terms to any other bidder or potential bidder prior to the official bid opening.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature: __________________________________________
Printed Name: _______________________________________
Title: _______________________________________________
Date: _______________________________________________
Notary Public Signature (if required): ______________________
Commission Number: _________________________________
Expiration Date: _______________________________________
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