Non-Collusion_Affidavit_.pdf

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Attached to
Invitation to Bid Parking Lot Rehabilitation (3)
Solicitation number
2025-PWP-014
Issued by
Marion County, Indiana

About this file

This is a Non-Collusion Affidavit form associated with an Invitation to Bid for Parking Lot Rehabilitation issued by the Board of Public Works of the City of Bloomington, Indiana. The affidavit serves as a sworn statement required from bidders participating in the sealed bid procurement process, which is conducted through the City's procurement portal at https://procurement.opengov.com/portal/bloomingtonin. The form does not contain specific information regarding project scope, quantities, timelines, site visits, or bidders' meetings; rather, it functions as a mandatory compliance document for bid submission.

The affidavit requires the undersigned offer or agent to affirm under penalties of perjury that no collusion, combination, or agreement has occurred regarding bid pricing or the prevention of competing offers. The form must be notarized and completed with the organization name, signatory name and title, date, notary information, and the notary's commission expiration date. This document is a standard procurement requirement intended to ensure fair and competitive bidding practices and does not address pricing terms, set-asides, incumbents, or funding sources for the parking lot rehabilitation project.

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NON-COLLUSION AFFIDAVIT

The undersigned offer or agent, being duly sworn on oath, says that he 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 offered by any person nor to prevent any person from making an offer nor to induce anyone to refrain from making an offer and that this offer is made without reference to any other offer.

OATH AND AFFIRMATION

I affirm under the penalties of perjury that the foregoing facts and information are true and correct to the best of my knowledge and belief.

Dated this day of , 20 .

(Name of Organization)

By: _

(Name and Title of Person Signing)

STATE OF )

) SS:

COUNTY OF )

20__.

Subscribed and sworn to before me this day of _

My Commission Expires:

Notary Public Signature

Resident of County Printed Name

NON-COLLUSION AFFIDAVIT
OATH AND AFFIRMATION

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