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

Non-Collusion Affidavit Summary

This document is a Non-Collusion Affidavit form required by the City of Bloomington, Indiana Board of Public Works for the Parking Lot Rehabilitation project. The affidavit must be completed and submitted by all bidders as part of their sealed bid package. The undersigned offeror or agent certifies under oath that neither they nor any representative of their firm has entered into any combination, collusion, or agreement with any other person regarding pricing, bid suppression, or bid inducement. The affidavit requires the organization name, signature of an authorized representative with title, date, and notarization before a Notary Public. Sealed bids for the three-lot parking rehabilitation project must be submitted electronically through the OpenGov e-Procurement Portal by December 15, 2025 at 12:00 p.m., with public bid opening occurring on the same date. Project commencement is scheduled for June 1, 2026, with a 45 calendar day completion timeline.

The Non-Collusion Affidavit is a compliance requirement binding all bidders to affirm the integrity of the bidding process without price-fixing, bid-rigging, or collusive practices. This certification is a standard procurement protection mechanism required in addition to other mandated documentation including State Form 96, E-Verify Affidavit, and contract compliance certification. The affidavit must be executed under penalties of perjury, making false statements a criminal matter. No specific pricing information, set-asides, or financial incentives are contained within this form itself; rather, it serves as a legal safeguard to ensure competitive bidding integrity for the approximately 63,650 square feet of parking lot rehabilitation work across three Bloomington locations.

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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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