Fillable Printable Non-Collusion Affidavit - Oregon
Fillable Printable Non-Collusion Affidavit - Oregon
Non-Collusion Affidavit - Oregon
Non-Collusion Affidavit – Page 1
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NON-COLLUSION AFFIDAVIT
1) This Non-Collusion Affidavit is material to any Contract awarded pursuant to the bid.
According to the Oregon Public Contracts and Purchasing Laws, a public contracting agency
may reject any or all bids upon the finding by the agency that it is in the public interest to do
so (ORS 279.035). This public contracting agency finds that it is in the public interest to
require the completion of this affidavit by potential Contractors.
2) This Non-Collusion Affidavit must be executed by the member, officer, or employee of the
Bidder who makes the final decision for price(s) and the amount(s) quoted in the bid.
3) Bid rigging and other efforts to restrain competition and the making of false sworn
statements in connection with the submission of bids are unlawful and may be subject to
criminal prosecution. The person who signs the Affidavit should examine it carefully before
signing and assure themselves that each statement is true and accurate, making diligent
inquiry, as necessary, of all other persons employed by or associated with the Bidder with
responsibilities for the preparation, approval, or submission of the bid.
4) In the case of a bid submitted by joint venture, each party to the venture must be identified in
the bid documents, and an Affidavit must be submitted separately on behalf of each party.
5) The term “complimentary bid” as used in the Affidavit has the meaning commonly
associated with that term in the bid process and includes the knowing submission of bids
higher than the bid of another firm, any intentionally high or non-competitive bid, and any
other form of bid submitted for the purpose of giving a false appearance of competition.
6) Failure to file an Affidavit in compliance with these instructions may result in
disqualification of the bid.
Non-Collusion Affidavit – Page 2
STATE OF OREGON )
)ss
County of )
I state that I am ,
Print/Type – Name Print/Type – Position Title with Firm/Company
representing
Print/Type – Name of Firm/Company
and that I am authorized to make this affidavit on behalf of my Firm/Company, and its owners,
directors, and/or officers. I am the person responsible in my Firm/Company for the price(s) and
the amount(s) provided in this Proposal.
I state that:
1) The price(s) and the amount(s) provided in this bid have been arrived at independently and without
consultation, communication, or agreement with any other Contractor, Bidder, or potential Bidder,
except as disclosed on the attached appendix to this Non-Collusion Affidavit.
2) Neither the price(s) nor the amount(s) provided in this bid, and neither the approximate price(s) nor
approximate amount(s) provided in this bid, have been disclosed to any other Firm/Company or
person who is a Bidder or potential Bidder, and they will not be disclosed before the bid opening.
3) No attempt has been made or will be made to induce any Firm/Company or person to refrain from
Bidding on this contract, or to submit a bid with price(s) and/or amount(s) higher than this bid, or
submit any intentionally high or noncompetitive price(s) and/or amount(s) in a bid or other form of
complementary bid.
4) The price(s) and/or amount(s) provided in this bid on behalf of my Firm/Company is made in good
faith and not pursuant to any agreement or discussion with, or inducement from, any Firm/Company
or person to submit a complementary or other non-competitive bid.
5) My Firm/Company, its affiliates, subsidiaries, officers, directors, and/or employees are not currently
under investigation by a governmental agency. They have not in the last four years been convicted of
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 described on the attached
appendix to this Non-Collusion Affidavit.
I state that my Firm/Company understands and acknowledges that the representations are
material and important and will be relied on by the City of Pendleton in awarding the Contract(s)
for which this Bid is submitted.
I understand, and my Firm/Company understands, that any misstatement in this affidavit is and
shall be treated as fraudulent concealment from the City of Pendleton of the true facts relating to
the submission of the Bid for this Contract(s).
Signature – Name
This instrument was acknowledged before me this day of , 2010.
Before me:
Notary Public for Oregon
(SEAL) My Commission Expires:
