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
This document is a Non-Collusion Affidavit issued by the City of Lompoc's Purchasing Department, located at 100 Civic Center Plaza, Lompoc, CA 93436. The form is designed to be completed by bidders participating in a city procurement process, requiring the authorized representative to swear under penalty of perjury that their bid submission is genuine and not the result of collusive practices.
The affidavit compels the bidder to affirm that neither they nor their associated parties have engaged in anti-competitive behaviors such as conspiring with other bidders, receiving improper considerations, or disclosing bid details prematurely. The document provides spaces for the bidder to enter project-specific information including project name, solicitation number, company details, and requires signatures from the authorized representative and potentially a notary public. Contact information for the Lompoc Purchasing Department is provided, including phone, fax, and email for potential follow-up or inquiries.
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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 .