Sun Upt:
firr ~
~"' PROPOSAL FOR
TOWN OF WAPPINGER
UNITED WAPPINGER WATER DISTRICT
~ WATER MAIN EXTENSION TO CHELSEA HAMLET
.., CONTRACT NO. 13-006
DIVISION 200
BID FORM
PREPARED BY:
MORRIS ASSOCIATES
ENGINEERING CONSULTANTS, PLLC
9 ELKS LANE
POUGHKEEPSIE, NEW YORK 12601
SEPTEMBER 2013
REVISED FEBRUARY 2014
MA#: W21215.11
I
.., 2QQ Q 1
TOWN OF WAPPINGER
UNITED WAPPINGER WATER DISTRICT
WATER MAIN EXTENSION TO CHELSEA HAMLET
CONTRACT NO. 13-006
BID FORM
THE 70WN RESERVES THE RIGHT TO REJECT ANY OR ALL BIDS. EACH BID FORM
SHALL BE ACCOMPANIED BY BID SECURITY (AS DESCRIBED IN THE INSTRUCTION
TO BIDDERS).
TO THE TOWN BOARD, TOWN OF WAPPINGER, NEW YORK
Pursuant to and in compliance with your invitation to bid contained in the Notice to
Contractors dated tY1 ~-r,F, 3 , ~ o I ,
+~ (month) (day) (year)
the undersigned hereby proposes to furnish all labor, machinery, equipment, facilities,
~- tools, transportation, supplies, materials, insurances, permits, certificates, tests,
guarantees, protection of equipment and property and life during construction; as well as
competent and qualified supervision for alf phases of the work, and other facilities and
things necessary or proper for or incidental to, Town of Wappinger Water Main Extension
to Chelsea Hamlet Project, Town of Wappinger, as required by an in ~®
with the plans, specifications and all other documents relating to Co trac
~"' the prices stipulated and as shown on this bid form.
MAR 31 2014
Name of Bidder:
SUN UP E
(Individual, Partnership,
* Circle applicable
w
~-~
r
a
fir-
6 ~VyLI~~F WAPPINGER
TOWN CLERK
The undersigned declares that the bidding and contract documents have been carefully
examined and that all things necessary for the completion of the work shall be provided.
Receipt of the following addenda is hereby acknowledged:
ADDENDUM NO. 1
ADDENDUM NO. 2
ADDENDUM NO. 3
ADDENDUM N0.4
DATE
3-a I- i~
~-as--~
200 02
3
In consideration of, and to induce the award of this contract to him/her, the bidder
represents and warrants that:
(a) If this bid is accepted by the Town Board, Town of Wappinger, as evidenced
by issuance of a Notice of Award by the Owner, and mailed by registered
ma+I with return receipt requested to the address of the bidder as i~ridicated
on his/her bid, the bidder will execute a contract on the form of agreement
herein provided and will comply with all provisions of said Notice of Award.
(b) This bid is made without any understanding, agreement or connection with
any other person, firm or corporation making a bid for the same work, and
that it is in all respect fair and without collusion or fraud.
(c) The bidder has carefully examined and fully understands all of the parts of
the contract documents, and that the bidder will execute the contract and will
completely perform it in strict accordance with the provisions thereof for the
sum set forth on the bid. Unit Prices have been computed in accordance with
the Contract Documents. Bidder acknowledges that estimated quantities are
not guaranteed, and are solely for the purpose of comparison of Bids, and
final payment for all Unit Price Bid items will be based on actual quantities,
determined as provided in the Contract Documents.
(d) No officer or employee of the Town Board, Town of Wappinger, or any
person whose salary is payable in whole or in part by the Town Board is,
shall be, or shall become interested directly or indirectly as a contracting
party, partner, stockholder, surety or otherwise in this bid or in the
performance of the contract or in the supplies, materials or equipment, or to
work or labor to which it relates, or in any portion of the profits thereof.
(e) The bidder is not in arrears to the Town Board upon debt or contract and is
not a defaulter as surety, contractor, or otherwise upon any obligation to the
Town Board, Town of Wappinger.
(f) All work shall be completed within the time allotted, from the date specified in
the Notice to Proceed or set by the contract documents, mailed to the
undersigned by registered mail with return receipt requested to the legal
address of the bidder as indicated on his/her bid.
(g) If the bid documents contain any unlawful provision not an essential part of
the bid and which shall not appear to have been a controlling or material
inducement to the making thereof, the same shall be deemed of no effect
and will upon notice by either the Owner or the bidder be deemed stricken
from the bid documents without affecting the binding force of the remainder.
200 03
(h) Each and every provision of any law and clause required by law to be
inserted in the bid documents shall be deemed to be inserted herein and the
bid documents shall be read and enforced as though it were included herein;
and if through mistake or otherwise any such provision is not inserted or is
not correctly inserted, then upon the application of either party, the bid
.documents shall forthwith be physically amended to make such insertion.
(i) The bidder is financially solvent and sufficiently experienced and competent
to perform the work.
(j) The work can be performed as called for by the proposal and that the plans
and specifications are in all respects suitable and adequate for the work.
(k) The facts stated in his/her bid and the information given by him/her are true
and correct in all respects.
(I) The bidder is fully informed regarding all the conditions affecting the work to
be done and labor and materials to be furnished for the completion of this
contract, and that his/her information was secured by personal investigation
and research.
(m) In the event of a lawsuit, the bidder agrees that said suit shall be filed in the
same county as the location of the project.
BID FOR CONTRACT WORK:
it Base Bid
Install water distribution improvements and related items in accordance with the Contract
Documents, not including Bid Alternate 1. The signatory to this bid, for all work proposed,
items furnished and strict compliance with all provisions of each and every Contract
Document relating to Contract 13-006, agrees to accept (unless modified pursuant to the
terms of the General Conditions) a total, final and fixed contract price not to exceed:
~ ~,~, c .~
(Word) ~,.~`~ ~- ~`QV /~~~'~~",`,°
~ ~f3si ~ts~b~
(Figures)
~~~~a~~~
MAR 31 2014
~` TOWN OF WAPPINGER
Zoo 04 TpW N .CLERK....
p,,, Add Alternate 1 Bid
For Add Alternate 1: Overlay paving of Entire Stenger Court, the signatory to this bid, for
,.,, all work proposed, items furnished and strict compliance with all provisions of each and
every Contract Document relating to Contract 13-006, agrees to accept (unless modified
pursuant to the terms of the General Conditions) a total, final and fixed contract price not to
~. exceed : 6
$ ~ ~ ~d ~.sl ~ /U D
(Words)
~,,,, $ (~ s`~ DU 0 ~ p ~
(Figures)
Add Alternate 2 Bid
For Add Alternate 2: Electrical Service for Pressure Reducing Vault, the signatory to this
bid, for all work proposed, items furnished and strict compliance with all provisions of each
and every Contract Document relating to Contract 13-006, agrees to accept (unless
modified pursuant to the terms of the General Conditions) a total, final and fixed contract
,,,, price not to exceed: ~'
$ _~.~c(C.eJ.. `7~t~t~s>c°.~ /~ 77~-~tdJtz of '` ~/!ID
~, ,~ (Words)
$ ~~, amp ,
(Figures)
Also made a part of this bid is d doc n tion per Division 100, Article C.3.
`' Sign Bid Here
A T D SIGNATU
`.~ Print Name 1-4c~ro 1 ~ l,J (~ uc hn~-~'
~tle ~res~'de-~-~-
~~ ~~ ~ SUN. UP ENTERPRISES, INC,
o ~~ (3,ff dial Company Name
~~ ti Q ~r°` (Individual, Partnershi ,Corporation, LL )*
~" ~ ~ ~ ~C/; Circle applicable
Q ~ w
p~ ~ ~~pany
~Al~ling Address
~ ,
~ ~Q 1607 Route 376
~• ~~~ cl appmgers IP coDE
Federal Employer
Identification No. I y - - (oa c~ 3 ~ ~
Telephone No. $ `f5 - 4 ~~ - I ~ot~
200 05
(If bidder is a corporation, fill in the following blanks.)
Organized under the laws of the State of: ~ 2ey ~ o~ k
Name and Address of President: (fir, ~ ~~ tA~ ~~P.~-n ~ -
Name and Address of Secretary: ~ a r0 ~ e S ~JuGhne~
~'S ~a.~Q a S ~.r~ p G~ 9< o~ n~~ N `I I a L o~
Name and Address of Treasurer: ~a.~'a~ c S ~uC~1ne~
R' -Da,1,~ Q s ~ r . ~,~~~ti~.(~yy DSi ~ . I~ `f I a ~ a 3
(If bidder is a Limited Liability Company, fill in the following blanks.)
Organized under the laws of the State of:
Name of Manager or Managing Member:
Agent for Service of Process:
Address for Service of Process:
MAR 31 2014
TOWN OF WAPPI ~ ER
TOWN CLER
200 06
STATE OF NEW YORK )
ss:
COUNTY OF ~ti~'GE~eSS )
On the 31 ~ day of ,iUar~ a ~ I `-f ,before me, the
undersigned, a Notary Public in and for said State, personally appeared ,gold ~ ~,~~~n ~/
personally known to me or proved to me on the basis of satisfactory evidence to be the
individual whose name is subscribed to the within instrument and acknowledged to me that
he executed the same in his capacity, and that by his signature on the instrument, the
individual, or the person upon behalf of which the individual acted, executed the
instrument. ~4-5 -`~--
C~'1^JA ~ F~~~l?I
I~!otary P ~.. ~ ~` ,' ~~"~w York
Cpl 't.'i;~ ~ L7 i'~ J ~1 i.:. r "r~i'3l
Q~_ i' ~ ~ t i r_ ~~ i~ U I"l Yy
~iOflllifi ~Slu~t ~Xj.,liCo ~i~iu~ ~/, ZU ~~
NOTARY PUBLIC
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BID BOND
If a bond is used, the form bound in this manual should be used. No other form
may be used except with prior approval by the Owner after review by the Town
Attorney which approval may be granted or withheld, in the Owner's discretion.
Zoo os
BID BOND
KNOW ALL MEN BY THESE PRESENTS: that
* Sun Up Enterprises Inc
as Principal; and
** Travelers Casualty and Surety Company of America as Surety,are hereby
held and firmly bound unto the Town Board, Town of Wappinger, New York in the amount
Of: FIVE PERCENT OF ATTACHED BID Dollars ~ 5~a OF ATTACHED BID
for the payment whereof Principal and Surety bind ourselves, our heirs, executors,
administrators, successors and assigns, jointly and severally, firmly by these presents.
Signed this 25th
day of
March
2014
WHEREAS, the condition of the above obligation is such that, whereas the Principal has
submitted to the Town Board a certain bid, attached hereto and hereby made a part hereof,
to enter into a contract in writing for the Water Main Extension to Chelsea Hamlet for the
Town of Wappinger, New York, as shown and specified in Contract No. 13-006.
NOW THEREFORE,
(a) If said Bid shall be rejected, or in the alternate
(b) If said Bid shall be accepted and the Principal shall execute and deliver a
contract in the Form of an Agreement attached hereto (properly completed in
accordance with said Bid) and shall in all respects perform the agreement
created by the acceptance of said Bid, then this obligation shall be void.
Otherwise, the same shall remain in force and effect, it being expressly
understood and agreed that the liability of the Surety for any and all claims
hereunder shall, in no event, exceed the amount of this obligation as herein
stated.
The Surety, for value received, hereby stipulates and agrees that the obligations of said
Surety and its bond shall in no way be impaired or affected by any extension of the time
within which the Principal may accept such bid; and said Surety does hereby waive notice
of any such extension.
IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and
seals, and such of them as are Corporations have caused their Corporate seals to be
hereto affixed and these presents to be signed by their proper officers, the day and year
first set forth above.
(SEAL) Sun Up Enterprises Inc
*Insert Bidder's Name
**Inswt Surety's Name
PRINCIP
By
old u er, President
200 09
NOTARIAL JURAT
INDIVIDUAL ACKNOWLEDGMENT
State of
County of
On this day of
,before me personally came
to me known and known to me to be the individual(s) who executed the foregoing instrument and
acknowledge to me that he/she/they executed the same.
Notary Public
PARTNERSHIP ACKNOWLEDGMENT
State of }
County of }
On this ,day of
,before me personally came
to me known and known to me to be a member of the partnership of
acknowledged that he/she executed the foregoing instrument as the
act of the said partnership.
Notary Public
CORPORATION ACKNOWLEDGMENT
State of }
County of }
On this day of ,before me personally came
to me known, who, being by me duly sworn, did depose and say that he/she resides in
;that he/she is the of the
the corporation which executed the foregoing instrument; that he/she
knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that is
was so affixed by order of the Board of Directors of the said corporation, and that he/she signed his/her name
to the instrument by like order.
Notary Public
SURETY ACKNOWLEDGMENT
State of New York
COUnty Of Dutchess
On this 25th day of March , 2014 ,before me personally came Carmel la M Crassi
to me known, who being by me duly sworn, did depose and say: that he/she resides in the City of Ki ngston
that he/she is Attorney-in-Fact of the above signed surety, the corporation described in and which executed
the foregoing instrument; that he/she knows the corporate seal of said corporation; that the seal affixed to
said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said
corporation; and that he/she signed his/her name thereto by like orde .
SUSAN L. PROVOST ~,, `
Notary Public, State of New York Notary Public
Qualified in UlstAr County
Rag. No, 01 PR4984712
Commission Expires July 29, 20.L~
,~~ POWER OF ATTORNEY
TRAVELERS J Farmington Casualty Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St. Paul Guardian Insurance Company
Attorney-In Fact No. 224598 Certificate No. ~ ~ ~ 8 ~ 3 8
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Mazine Insurance Company, St. Paul Guardian Insurance
Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the
laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint
Frank S. Maranto Jr., Kevin A. Viana, Mary Ann Szczypca, Timothy Rychcik, Susan Provost, Kathleen A. Brown, Carmella M. Grassi, and
Eleanor Menges
of the City of Poughkeepsie ,State of New YOt'k ,their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted' in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and theircorporate seals to be hereto affixed, this
day of March 2014
5th
Farmington Casualty Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St. Paul Guardian Insurance Company
GI.SUq~ ~ yFIRE 4 \'N ~RSG Y..+ 1• N"S"U.'A 4 P~(V qRO _e\[tY
O OP'P~Il ~' G~ 7P fGpRVORq> ~! PU .:: ~:bCsi u G'~ '~ Q
~ g RPORq
u sl9S2e' O 7t NCOIiP4tAttD ?, m~ ~. Fih„ '°`w~.~Tf~•~~ ~' ~ ~ ~
_,.., f E . ~ { a HARTFORD, •c HliRTFffRtA~ <
2 i 1977 ~` n ~ i ' o r 1886
~y~cr~~a ~~' 1951 ti o. ~~.SEAL ~od ~~;,SSAL;%D ~, CONN. ro ~ ~~
y ' ~ ~w,w ~ ;',~ E 1SN AN~ 1r.... *d df nNa t „ v AY! A1N
.. ,~
State of Connecticut
City of Hartford ss.
By:
Robert L. Raney, enior Vice President
On this the 5th day of March 2014 before me personally appeared Robert L. Raney, who aclmowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul
Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers
Casualty and Surety Company of America, and United States Fidelity and Guazanty Company, and that he, as such, being authorized so to do, executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
~G.T~~
In Witness Whereof, I hereunto set my hand and official seal. ~
My Commission expires the 30th day of June, 2016. ~ 1°t~eu~~*
Mazie C. Tetreaul[, Notary Public
58440-8-12 Printed in U.S.A.
THIS
TRAVELERS CASUALTY AND SURETY C06r1PANY OF AMERICA
HARTFORD, CONNECTICUT 06183
FINANCIAL STATEMENT AS OF JUNE 30, 2013
AS FILED IN THE STATE OF NEW YORK
CAPITAL STOCK $ 6,480,000
ASSETS LIABILITIES F< SURPLUS
SASH AND INVESTED GASH ~ $ 73,801,790 UNEARNED PREMIUMS $ 783,168,755
30NDS 3,656,149,712 LOSSES 840,116,078
NVES7MENT INCOME DUE AND ACCRUED 49,212,212 LOSS ADJUSTMENT EXPENSES 533,100,921
ETHER INVESTED ASSETS 270,012,328 COMMISSIONS 20,392,790
'REMIUM BALANCES 222,863,968 TAXES, LICENSES AND FEES 13,766,466
VET DEFERRED TAXASSET 62,625,330 OTHER EXPENSES 23,635,903
1EINSURANCE: RECOVERABLE 8,556,480 FUNDS HELD UNDER REINSURANCE TREATIES 94,428,218
iECURITIES LENDING REINVESTED COLLATERAL ASSETS 2,859,442 CURRENT FEDERAL AND FOREIGN INCOME TAXES 26,520,048
RECEIVABLES FROM PARENT, SUBSIDIARIES AND AFFiIIATES 48,995,467 REMITTANCES AND ITEMS NOT ALLOCATED 16,953,354
7ERIVATIVES 629,474 AMOUNTS WITHHELD /RETAINED BY COMPANY FOR OTHERS 32,952,885
ETHER ASSETS 529,004 RETROACTIVE REINSURANCE RESERVEASSUMED 3,215,131
POLICYHOLDER DIVIDENDS 7,071,676
PROVISION FOR REINSURANCE 5,314,325
ADVANCE PREMIUM 636,242
PAYABLE FOR SECURITIES LENDING 2,859,442
PAYABLE FOR SECURTIES 5,888,369
CEDED REINSUFJINCE NET PREMIUMS PAYABLE (33,835,b98)
ESCHEAT UABiLITY 523,371
OTHER ACCRUED EXPENSES AND LIABILITIES 373 980
TOTAL LIAB1L1T1ES $ 2 3356
CAPITAL STOCK $ 6,480,000
PAID IN SURPLUS 433,803,760
OTHER SURPLUS 1,578,869,089
TOTAL SURPLUS TO POLICYHOLDERS $ 2,019,152.849
TOTAL ASSETS _ $ 4,39~~235,205 TOTAL LIABILITIES 8 SURPLUS $ 4,396,235,205
STATE OF CONNECTICUT )
:OUN7Y OF HARTFORD ) SS.
;ITY OF HARTFORD 3
AICHAEL J. DOODY, BEING DULY SWORN, SAYS THAT HE IS SECOND VICE PRESIDENT, OF TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA,
1ND THATTO THE BEST OF HIS KNOWLEDGE AND BELIEF, THE FOREGOING 1S ATRUE AND CORRECT STATEMENT OF THE FINANCIAL CONDi1TON OF SAID
AMPANY AS OF THE 30TH DAY OF JUNE, 2013.
SUBSCRIBED AND SWORN TO BEFORE ME THlS
?0TH DAYOF AUGUST, 2013
~~ ~ `~' ~-
~ ~ i ~~-
n ti t'J' ~3 ~S.C~
SJ• T•.
,~
SECOND VICE PRESIDENT'
i~•---.. G i ...,~t
NOTARY PUBLIC
SUSAN M. NEISSLEDER
Notary P:rGlic
Rip Cannnission Erplres Nol~ember 30, 2017
+ir
P
BID BOND
KNOW ALL MEN BY THESE PRESENTS: that
**
as Principal; and
as Surety, are hereby
held and firmly bound unto the Town Board, Town of Wappinger, New York in the amount
of: Dollars $
for the payment whereof Principal and Surety bind ourselves, our heirs, executors,
administrators, successors and assigns, jointly and severally, firmly by these presents.
Signed this
day of
20
WHEREAS, the condition of the above obligation is such that, whereas the Principal has
submitted to the Town Board a certain bid, attached hereto and hereby made a part hereof,
to enter into a contract in writing for the Water Main Extension to Chelsea Hamlet for the
Town of Wappinger, New York, as shown and specified in Contract No. 13-006.
r NOW THEREFORE,
(a) If said Bid shall be rejected, or in t~e alternate
(b) If said Bid shall be accepted and the Principal shall execute and deliver a
contract in the Form of an Agreement attached hereto (properly completed in
accordance with said Bid) and shall in all respects perform the agreement
created by the acceptance of said Bid, then this obligation shall be void.
Otherwise, the same shall remain in force and effect, it being expressly
understood and agreed that the liability of the Surety for any and all claims
hereunder shall, in no event, exceed the amount of this obligation as herein
stated.
The Surety, for value received, hereby stipulates and agrees that the obligations of said
~"' Surety and its bond shall in no way be impaired or affected by any extension of the time
within which the Principal may accept such bid; and said Surety does hereby waive notice
of any such extension.
W
IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and
seals, and such of them as are Corporations have caused their Corporate seals to be
hereto affixed and these presents to be signed by their proper officers, the day and year
first set forth above.
(SEAL)
~' PRINCIPAL
*Insert Bidder's Name
**lnsert Surety's Name By
200 09
r.
Signed, sealed and de
in the presence of _
(Corporate seal of Contractor
if a corporation)
Sun Uo Enterprises Inc
By
1 d B~i,G,hrfer, Presi den
Travelers Casualty and Surety Company of America
r
By 2, n,
Carmel l a M J Crassi (Title f Officer Attorney-i n-Fact
(Corporate seal of /f
Surety) Attest C~-
Kath een A. Brown (Title Of Officer) Attorney-i n-Fact
200 Q'10
STATE OF NEW YORK )
ss:
COUNTY OF Dutchess )
On the ~5°~' day of -'Y~Ar c ~ ~ n ~ `-i ,before me, the
undersigned, a Notary Public in and for said State, personalty appeared Harold Buchner
personally known to me or proved to me on the basis of satisfactory evidence to be the
.individual whose name is subscribed to the within instrument and acknowledged to me that
y - " he executed the same in his capacity, and that by his signature on the instrument, the
individual, or the person upon behalf of which the individual acted, executed the
instrument.
~,i~r~~~ r" Fnq"~?I
_., ~~
-~intary Pty.. _ w York
Cr;~ , i ~ _ ~.u2i7
C _ r ~ ,r ~ ,::anty ,`
~~
NOTARY PUBLIC
200 11
w
CERTIFICATION OF NON-COLLUSION BY BIDDER
No bid will be considered unless this Certification remains attached tto~ and is submitted with the Bid
SLIN t~P ENTERPRI5E5, 9NG,
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 his 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 bylaw the prices which have been quoted in this bid have not
knowingly been disclosed by the bidder and will not knowingly be disclosed by the
bidder, directly or indirectly, to any other bidder or to any competitor, before the time of
the bid opening.
(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 to submit a bid for the purpose of restricting
competition.
A bid shall not be considered for award nor shall any award be made where (1) (2) and
(3) above have not been complied with; provided however, that if in any case the bidder
cannot make the foregoing certification, the bidder shall so state and shall furnish with
the bid a signed statement which sets forth in detail the reasons therefore. Where (1) (2)
and (3) above have not been complied with, the bid shall not be considered for award ,
nor shall any award be made unless the head of the purchasing unit of the State, public ~ ~.
department or agency to which the bid is made, or his designee, determines that such
disclosure was not made for the purpose of restricting competition.
(4) 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 of subparagraph (1).
(5) Any. bid hereafter made to any public authority or to any official of any public authority
created by the State or any political subdivision, by a corporate bidder for work of
services performed or to be performed or goods sold or to be sold where competitive
bidding is required by statute, rule, regulation, or local law, and where such bid contains
the certification referred to in the lead paragraph of this 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.
I affirm these statements unde~alty of perjui
BIDDER'S SIGNATU
DATE: J7 ~ ~~ I - ~ ~ j'l
~~ 't2