Non-Collusion_Affidavit_USDA.pdf
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- Solicitation number
- 26172-ITB-DST
- Issued by
- Florida
About this file
This is a Non-Collusion Affidavit form used by the United States Department of Agriculture (USDA) for procurement purposes. The affidavit is applicable to the Hillsborough County Public Schools' Student Nutrition Services contract opportunity for customized informational station panels. The document serves as a declaration that the bidder has not engaged in collusive practices with other bidders or parties to secure the contract. The affidavit must be executed by an authorized representative of the bidding entity and submitted as part of the proposal package. This certification is required to ensure fair and open competition among qualified vendors seeking to supply a minimum of 136 customized informational station panels (86 three-panel stations and 50 five-panel stations) to the SNS Warehouse.
The Non-Collusion Affidavit is a mandatory compliance document that protects the integrity of the procurement process by requiring bidders to attest under oath or affirmation that no collusion has occurred. Submission of this affidavit is a prerequisite for bid consideration, and false statements made in the affidavit may result in criminal penalties. The form establishes legal accountability and ensures that all bidders compete on equal terms without anticompetitive arrangements, thereby protecting the public interest and the school district's procurement objectives.
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Text version
Rev. May 2021
NON-COLLUSION AFFIDAVIT
STATE OF FLORIDA
COUNTY OF ______________________
_______________________________________ (VENDOR) being first duly sworn, deposes, and says that:
(FSMC Official)
VENDOR is the ____________________________________ of _____________________________________, (Owner, Partner, Officer, Representative, Agent) (Vendor)
VENDOR is fully informed respecting the preparation and contents of the attached proposal and of all pertinent circumstances respecting such proposal;
Such proposal is genuine and is not a collusive or sham proposal;
Neither the said VENDOR nor any of its officers, partners, owners, agents, representative, employees or parties in interest, including this affidavit, have in any way colluded, conspired, connived or agreed, directly or indirectly, with any other VENDOR, firm or person to submit a collusive or sham proposal in connection with the contract for which the attached proposal has been submitted; or to refrain from proposing in connection with such contract; or have in any manner, directly or indirectly, sought by agreement or collusion, or communications, or conference with any VENDOR, firm, or person to fix the price or prices in the attached proposal or any other VENDOR, or to fix any overhead, profit, or cost element of the proposal price or the proposal price of any other VENDOR, or to secure through any collusion conspiracy, connivance, or unlawful agreement any advantage against the SFA, or any person interested in the proposed contract;
The price of items quoted in the attached proposal are fair and proper and are not tainted by collusion, conspiracy, connivance, or unlawful agreement on the part of the VENDOR or any of its agents, representatives, owners, employees, or parties in interest, including this affidavit.
By _______________________________
Subscribed and sworn to before me this _____ day of _________________________, 20____.
Notary Public (Signature)
My Commission Expires:
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