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Representations, Certifications,
and Other Statements of Bidders
Public and Indian Housing Programs
Table of Contents
Clause Page
1. Certificate of Independent Price Determination 1
2. Contingent Fee Representation and Agreement q
3. Certification and Disclosure Regarding Payments
to Influence Certain Federal Transactions 1
4. Organizational Conflicts of Interest Certification 2
5. Bidder's Certification of Eligibility 2
6. Minimum Bid Acceptance Period 2
7. Smail, Minority, Women-Owned Business Concern
Representation 2
8. Indian-Owned Economic Enterprise and Indian
Organization Representation 2
9. Certification of Eligibility Under the Davis-Bacon Act 3
10. Certification of Nonsegregated Facilities 3
11. Clean Air and Water Certification 3
12. Previous Participation Certificate 3
13. Bidder's Signature 3
1. Certificate of Independent Price Determination
{a) The bidder certifies that--
(1) The prices in this bid have been arrived at independently,
without, for the purpose of restricting competition, any consultation,
communication, or agreement with any other bidder or competitor
telating to (i) those prices, (ii) the intention to submit a bid, or (iti) the
methods or factors used to calculate the prices offered;
(2) The prices in this bid have not been and will not be
knowingly disclosed by the bidder, directly or indirectly, to any other
bidder or competitor before bid opening (in the case of a sealed bid
solicitation) or contract award (in the case of a competitive proposal
solicitation) unless othenwvise required by law; and
(3) No attempt has been made or will be made by the bidder to
induce any other concern to submit or not to submit a bid for the
purpose of restricting competition.
(b} Each signature on the bid is considered to be a certification by
the signatory that the signatory--
(1) Is the person in the bidder's organization responsible for
determining the prices being offered in this bid or proposal, and that
the signatory has not participated and will not participate in any
action contrary to subparagraphs (a)(I) through (a)(3) above; or
(2) (i) Has been authorized, in writing, to act as agent for the
following principals in certifying that those principals have not
participated, and will not participate in any action contrary to
subparagraphs (a)(I) through (a)(3) above.
[insert
full name of person(s) in the bidder's organization responsible for
determining the prices offered in this bid or proposal, and the title of
his or her position in the bidder's organization];
(i) As an authorized ageni, does certify that the principals
named in subdivision (b)(2}(i) above have not participated, and will
not participate, in any action contrary to subparagraphs (a)(1)
through (a)(3) above; and
{iii) As an agent, has not personally participated, and will
not participate in any action contrary to subparagraphs (a)(1)
through (a)(3) above.
(c) If the bidder deletes or modifies subparagraph (a)2 above, the
bidder must furnish with its bid a signed statement setting forth in
detail the circumstances of the disclosure.
[ ] [Contracting Officer check if following paragraph is applicable]
(d) Non-collusive affidavit. (applicable to contracts for construction
and equipment exceeding $50,000)
(1) Each bidder shall execute, in the form provided by the PHA/
IHA, an affidavit to the effect that he/she has not colluded with any
other person, firm or corporation in regard to any bid submitted in
response to this solicitation. If the successful bidder did not submit
the affidavit with his/her bid, he/she must submit it within three (3)
working days of bid opening. Failure to submit the affidavit by that
date may render the bid nonresponsive. No contract award will be
made without a properly executed affidavit,
(2) A fully executed "Non-collusive Affidavit” [ ]is, [ ]is not
included with the bid.
2. Contingent Fee Representation and Agreement
(a) Definitions. As used in this provision:
“Bona fide employee” means a person, employed by a bidder
and subject to the bidder's supervision and control as to time, place,
and manner of performance, who neither exerts, nor proposes to
exert improper influence io solicit or obtain contracts nor holds out
as being able to obtain any coniract(s) through improper influence.
“Improper influence" means any influence that induces or tends
to induce a PHA/IHA employee or officer to give consideration or to
act regarding a PHA/IHA contract on any basis other than the merits
of the maiter.
(b) The bidder represents and certifies as part of its bid that, except
for full-time bona fide employees working solely for the bidder, the
bidder:
(1) [ ] has, [ ] has not employed or retained any person or
company to solicit or obtain this contract; and
(2) [ ] has, [ ]has not paid or agreed to pay to any person or
company employed or retained to solicit or obtain this contract any
commission, percentage, brokerage, or other fee contingent upon or
resulting from the award of this contract.
{c) If the answer to either (a)(1) or (a)(2) above is affirmative, the
bidder shail make an immediate and full written disclosure to the
PHA/IHA Coniracting Officer. .
({d) Any misrepresentation by the bidder shall give the PHAJHA the
right to (1) terminate the contract; (2) at its discretion, deduct from
contract payments the amount of any commission, percentage,
brokerage, or other contingent fee; or (3) take other remedy
pursuant to the contract.
3. Certification and Disclosure Regarding Payments to
Influence Certain Federal Transactions (applicable to
contracts exceeding $100,000)
{a} The definitions and prohibitions contained in Section 1352 of
title 31, United States Code, are hereby incorporated by reference
in paragraph (b) of this certification.
Previous edition is obsolete
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