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Division of Central Services
COLLUSION AFFIDAVIT
As required by Section 139-d of the New York State Finance Law, the proposer certifies that:
Dated
(a)
the proposal has been arrived at by the proposer independently and has been
submitted without collusion with any other vendor of materials, supplies, or
equipment of the type described in the invitation for proposals, and
(b) the contents of the proposal have not been communicated by the proposer, nor, to
its best knowledge and belief, by any of its employees or agents, to any person not
an employee or agent of the proposer its surety on any bond furnished herewith
prior to the official opening of the proposal. The signature of the Contractor to this
contract shall be deemed a specific subscription to the certificate required
pursuant to Section 139-d of the State Finance Law and the Contractor affirms that
the statements therein contained are true under the penalties of perjury."
(c) No attempt has been made or will be made by the proposer to induce any other
person, partnership or corporation to submit or not to submit a proposal for the
purpose of restricting competition.
Signed
By
(President)
If a corporation, give the State of Incorporation, using the phrase "corporation organized under
the laws of
If a partnership, give names of partners, using also the phrase "co-partners trading and doing
business under the firm name and style of
If an individual using a trade name, give individual name, using also the phrase "an individual
doing business under the firm name and style of
PD-6 (3)