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BID PROPOSAL CERTIFICATIONS

Firm Name _____________________________________________________________________________________________

Business Address ________________________________________________________________________________________

Telephone Number _______________________________________ Date of Bid _____________________________________

General Bid Certification

The bidder certifies that he will furnish, at the prices herein quoted, the materials, equipment, and/or

services as proposed on this bid.

II.

Non-Collusive Bidding Certification

By submission of this bid proposal, the bidder certifies that he is complying with Section 103-d of the

General Municipal Law as follows:

Statement of non-collusion in bids and proposals to political subdivision of the state. Every bid or proposal here-after made

to a political subdivision of the state or any public department, agency or official thereof where competitive bidding is required

by statute, rule, regulation, or local law, for work or services performed or to be performed or goods sold or to be sold, shall

contain the following statement subscribed by the bidder and affirmed by such bidder as true under the penalties of perjury:

Non-collusive bidding certification.

A. By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint

bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of its knowledge and

belief:

(1) The prices in this bid have been arrived at independently without collusion, consultation, communication or

agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder

or with any competitor.

(2) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly

disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, directly or indirectly,

to any other bidder or to any competitor; and

(3) No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to

submit or not submit a bid for the purpose of restricting competition.

B. A bid shall not be considered for award no shall any award be made where A. (1) (2) and (3) above have not been complied

with; provided, however, that if in any case the bidder shall so state and shall furnish with the bid a signed statement which

set forth in detail the reasons therefore. Where A. (1) (2) and (3) above have not been complied with, the bid shall not be

considered for award nor shall any award by made unless the head of the purchasing unit of the political subdivision, public

department, agency or official thereof to which the bid is made, or his designee, determines that such disclosure was not

made for the purpose of restricting competition.

(1) The fact that a bidder (a) has published price lists, rates, or tariffs covering items being procured, (b) has

informed prospective customers of proposed or pending publication of new or revised price lists for such items,

or (c) has sold the same items to other customers at the same prices being bid, does not constitute, without more,

a disclosure within the meaning subparagraph one (a).

(2) Any bid hereafter made to any subdivision of the state or any public department, agency or official thereof

by a corporate bidder for work or services performed or to be performed or goods sold or to be sold, where

competitive bidding is required by stature, rule, regulation, or local law, and where such bid contains the

certification referred to in subdivision one of the section, shall be deemed to have been authorized by the

board of directors of the bidder, and such authorization shall be deemed to include the signing and

submission of the bid and the inclusion therein of the certificate as to non-collusion as the act and deed of

the corporation.

Authorized Signature _____________________________

Title ___________________________________________

Bid Proposal Certifications

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