Non_Collusion_Affidavit.pdf

PDF 74 KB Posted

Attached to
Office Supplies
Solicitation number
2025-RFQ-023DW
Issued by
Santa Barbara County, California

About this file

The document is a Non-Collusion Affidavit from the City of Lompoc's Purchasing Department, located at 100 Civic Center Plaza, Lompoc, CA. This standard form is designed to be completed by bidders participating in a city procurement process, with spaces to fill in specific project details such as project name, solicitation number, and bidder company information.

The affidavit requires the bidder's authorized representative to swear under penalty of perjury that their bid is genuine, not collusive, and that neither the company nor its representatives have engaged in bid rigging or anti-competitive practices. The document includes five key declarations, including statements that no collusion has occurred, no fees have been exchanged for bid manipulation, and the bidder has not disclosed bid prices to other potential bidders. The form requires the signature of the authorized representative, with optional notarization, and provides contact information for the Lompoc Purchasing Department, including phone, fax, and email.

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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: _______________________________________ mailto:purchasing@ci.lompoc.ca.us

File details come from the government source that posted it. Updated .