NON_COLLUSION_AFFIDAVIT.pdf
PDF 24 KB Posted
- Attached to
- Clay Center Road Path Construction and Culvert Replacement Project State and local contract opportunity
- Solicitation number
- 22-ENG-15
- Issued by
- Hamilton County, Indiana
About this file
The document is a Non-Collusion Affidavit (State Form 4391) related to the Clay Center Road Path Construction and Culvert Replacement Project for the City of Carmel, Hamilton County, Indiana. The project involves constructing a 10-foot wide multi-use path along the west side of Clay Center Road from Clay Spring Drive to 500 feet north of Brighton Avenue, including ditch grading, storm sewer installation, 8 curb ramps, and a mid-block crossing at Brighton Avenue. The project also includes replacing existing triple 84" pipes conveying Elliott Creek with a 64-foot 19'x7' reinforced coated concrete box structure, complete with headwalls, wingwalls, and pavement widening to provide adequate shoulder and turn-lane taper.
The Non-Collusion Affidavit is a standard form that requires the contracting party to swear under oath that they have not engaged in any collusive practices or paid any unauthorized consideration for the contract. Bids for this project will be accepted through the City's e-Procurement Portal until 9:00 am on Wednesday, April 2, 2025. The affidavit must be signed, notarized, and submitted as part of the bidding process, ensuring transparency and fair competition in the public procurement of this infrastructure improvement project.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 22-ENG-15_Construction_Plans_Addendum_2_Added.pdf | ||
| BID_BOND.pdf | ||
| 22-ENG-15_Technical_Specifications_Addendum_2_Added.pdf | ||
| Clay_Center_Road_Path_Construction_and_Culvert_Replacement_Project_(Addendum_#1_Revision).pdf | ||
| FIELD_ORDER.pdf | ||
| PERFORMANCE_BOND.pdf | ||
| SAMPLE_AGREEMENT.pdf | ||
| SUBCONTRACTORS_LIST.pdf | ||
| Exhibit_D_E-Verify-1.PDF | ||
| PAYMENT_BOND.pdf | ||
| RIGHT_OF_ENTRY.pdf | ||
| SCREENSHOT_INSTRUCTIONS_-_FOR_BIDS.pdf | ||
| WORK_DIRECTIVE_CHANGE.pdf | ||
| CONTRACT_CHANGE_ORDER.pdf | ||
| CONTRACT_CHANGE_REQUEST.pdf | ||
| MAINTENANCE_BOND.pdf | ||
| MANUFACTURERS_LIST.pdf | ||
| REQUEST_FOR_PROPOSAL_CHANGE.pdf | ||
| SAMPLE_OF_MOU_FOR_E-VERIFY.pdf | ||
| 6._Comprehensive_Set_of_Technical_Specifications_2021-04-28_(V2.7).docx | DOCX document |
Show all 20
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
NON-COLLUSION AFFIDAVIT
State Form 4391 (R4 / 1-00)
STATE OF: ________________________________________________
COUNTY OF _______________________________________________
} SS:
The undersigned, being duly sworn on oath says, that he is the contracting party, or that he is the representative, agent, member, or officer of the contracting party, that he has not, nor has any other member, employee, representative, agent or officer of the firm, company, corporation or partnership represented by him, directly or indirectly , entered into or offered to enter into any combination, collusion or agreement to receive or pay, and that he has not received or paid, any sum of money or other consideration for the execution of the annexed contract other than that which appears upon the face of the contract.
Signature
Printed name
Title
Company
Before me, a Notary Public in and for said County and State personally appeared, ______________________________________________ , who acknowledged the truth of the statements in the foregoing affidavit on this _______________________ day of ______________________, 20 ___ .
Signature of Notary Public
Printed or typed name of Notary PublicCounty of residence Commission expiration date
| state of: |
| county of: |
| signature: |
| title: |
| company: |
| before me: |
| this: |
| day of: |
| 00: |
| county of residence: |
| commission expires: |
| printed name: |
| sign of notary: |
| printed name1: |
File details come from the government source that posted it. Updated .