Non-Collusion_Affidavit.pdf
PDF 92 KB Posted
- Solicitation number
- 27-014
- Issued by
- Alameda County, California
About this file
This is a Non-Collusion Affidavit document associated with the City of Hayward's Request for Proposals (RFP) 27-014 for Third Party Administration of Workers' Compensation Benefits in California. The affidavit serves as a required certification form that proposing firms must submit as part of their sealed proposals to the City's eProcurement Portal. Proposals must be received by 4:00 pm on Friday, December 11, 2026, and clearly identified with the RFP title, number, company name, and due date. The document functions as a standard procurement compliance requirement, ensuring that bidders certify they have not engaged in collusive bidding practices and that their proposal prices are independently determined.
The Non-Collusion Affidavit is a mandatory submission requirement for all bidders participating in this procurement. This form obligates proposing firms to attest under penalty of perjury that they have not colluded with other bidders, competitors, or City officials regarding pricing, terms, or conditions of the proposal. By signing the affidavit, firms certify the independence and integrity of their bid submission. The document is a standard anti-competitive practice safeguard commonly required in public sector procurements to maintain fair competition and protect the government entity's interests in obtaining the best value for third-party workers' compensation administration services.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
*THIS DOCUMENT MUST BE COMPLETED, EXECUTED AND SUBMITTED WITH THE BID FORM*
NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED
WITH BID.
State of California )
) ss.
County of )
, being first duly ;sworn, deposes and says that he or she is of
_ the party making the foregoing bid that the bid is not made in the interest of or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder as not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder or t secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and further, that the bidder has not, directly or indirectly, submitted his or her bid price of any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid.
*NO BID IS VALID UNLESS SIGNED BY THE PERSON MAKING THE BID*
SIGNATURE:__________________________
PRINT NAME: _________________________
DATE: _______________________________
File details come from the government source that posted it. Updated .