NON_COLLUSION_AFFIDAVIT.pdf
PDF 24 KB Posted
- Attached to
- 25-STR-01 106th St Bridge Repair
- Solicitation number
- IFB-2024-018
- Issued by
- Hamilton County, Indiana
About this file
The document is a Non-Collusion Affidavit (State Form 4391) related to the 25-STR-01 106th St Bridge Repair project for the City of Carmel, Hamilton County, Indiana. This standard state form is designed to certify that the bidding party has not engaged in any collusive practices or agreements to manipulate the bidding process. The affidavit requires the signatory to swear that neither they nor any representatives of their company have entered into any combinations or agreements to receive or pay money beyond what is explicitly stated in the contract.
The associated contract opportunity involves a bridge repair project scheduled for bid submission by 9:00 am on Wednesday, January 22, 2025, through the City's e-Procurement Portal. The project scope includes replacing damaged bridge beams, repairing damages from vehicle collision, replacing ornamental railing, sidewalk, portions of the pier and end bent diaphragms, and other miscellaneous related work. The affidavit serves as a critical component of the bidding process, ensuring transparency and fair competition by requiring bidders to affirm they have not participated in any improper bidding practices.
View the file
Other files
Show all 20
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
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 .