COMMUNITY COLLEGE OF ALLEGHENY COUNTY
NON-COLLUSION AFFIDAVIT
Contract/Bid No. 1099
State of __________________________ :
:s.s.
County of ________________________ :
I state that I am ____________________________of_____________________________________ (title) (name of my firm)
and that I am authorized to make this affidavit on behalf of my firm, and its owners, directors, and officers. I am the person responsible in my firm for the price(s) and the amount of this bid.
I state that:
(1) The price(s) and amount of this bid have been arrived at independently and without consultation, communication or agreement with any bidder or potential bidder.
(2) Neither the price(s) nor the amount of this bid, and neither the approximate price(s) nor approximate amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder, and they will not be disclosed before bid opening. (3) No attempt has been made or will be made to induce any firm or person to refrain from bidding on this contract, or to submit a bid higher than this bid, or to submit any intentionally high or noncompetitive bid or other form of complementary bid.
(4) The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from, any firm or person to submit a complementary or other noncompetitive bid.
(5) ____________________________________________________, its affiliates, (name of my firm)
subsidiaries, officers, directors and employees are not currently under investigation by any governmental agency and have not in the last four years been convicted or found liable for any act prohibited by State or Federal law in any jurisdiction, involving conspiracy or collusion with respect to bidding on any public contract, except as follows:
I state that_____________________________________________________ understands and (name of my firm)
acknowledges that the above representations are material and important, and will be relied on by the Community College of Allegheny County in awarding the contract(s) for which this bid is submitted. I understand and my firm understands that any misstatement in this affidavit is and shall be treated as fraudulent concealment from the Community College of Allegheny County of the true facts relating to the submission of bids for this contract.
Signature________________________________________________ Title_________________________ (MUST BE SIGNED HERE IN HANDWRITING, IN INK.)
Sworn to and subscribed before me this _____________ day of ________________________, 20______
Notary Public__________________________________ My Commission Expires: __________________
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