Non-Collusion Affidavit32.docx

NON-COLLUSION AFFIDAVIT

Pursuant to the above referenced Roswell Park Comprehensive Cancer Center (“Roswell Park”) Request for Proposal (the “RFP”), the bidder identified on the last page of this Non-Collusion Affidavit (the “Bidder”) certifies that:

1. The pricing and Bid Response submitted by the Bidder has been arrived at independently and without consultation, communication, collusion, and/or agreement with any other company and/or person who is a bidder and/or potential bidder on the RFP, and has not been disclosed to any other company and/or person who is a bidder and/or potential bidder on the RFP, and will not be disclosed to any company and/or person who is a bidder and/or potential bidder on the RFP before the opening of the Bid Responses by Roswell Park;

2. No attempt has been made and/or will be made by the Bidder to induce any company and/or person to refrain from bidding on the RFP;

3. No attempt has been made and/or will be made by the Bidder to induce any other company and/or person who is a bidder and/or potential bidder on the RFP to submit any intentionally high and/or noncompetitive pricing and/or Bid Response;

4. The Bidder’s Bid Response is made in good faith and not pursuant to any agreement and/or discussion with any other company and/or person and/or inducement from any company and/or person to submit a complementary offer;

5. The Bidder, including its affiliates, subsidiaries, officers, directors, and employees are not currently under investigation by any governmental agency for any act prohibited by State and/or Federal law in any jurisdiction involving conspiracy and/or collusion with respect to bidding on any public contract, and have not, in the last four (4) years, been convicted of and/or found liable for any act prohibited by State and/or Federal law in any jurisdiction involving conspiracy and/or collusion with respect to bidding on any public contract; and

6. Neither Roswell Park nor any other company and/or person (including any company and/or person who is a bidder and/or potential bidder on this RFP) has, have, and/or will receive from the Bidder, either directly or indirectly, any gifts, commissions, and/or similar items of value in connection with this RFP.

Any defined terms in the RFP shall have the same respective meanings in this Non-Collusion Affidavit. The Bidder hereby warrants that by signing this Non-Collusion Affidavit, it is certifying that the above statements are true and accurate as they relate to the Bidder as of the date in which this Non-Collusion Affidavit is signed by the Bidder as indicated below. The Bidder understands and acknowledges that the above representations are material and important, and will be relied on by Roswell Park in awarding a Resultant Agreement. The Bidder understands and acknowledges that any misstatement in this Non-Collusion Affidavit is and shall be treated as fraudulent concealment from Roswell Park of the true facts relating to the submission of the Bidder’s Bid Response.

(Bidder)

Signature

Printed Name

Title

Date

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