29
ATTACHMENT NO. 3
SIGNATURE AFFIDAVIT
RFP No.
AUTOMATIC RADIO READ SYSTEM
NAME OF FIRM:
STREET
ADDRESS:
[COMPANY] ,
STATE, ZIP
CONTACT
PERSON:
PHONE #:
FAX #:
EMAIL:
In signing this bid, we also certify that we have not, either directly or indirectly, entered into any
agreement, participated in any collusion, or otherwise taken any action in restraint of free competition;
that no attempt has been made to induce any other person or firm to submit or not to submit a proposal;
that this RFP has been independently arrived at without collusion with any other proposer, competitor, or
potential competitor; that this RFP has not been knowingly disclosed prior to the opening of RFPs to any
other bidder or competitor; and that the above statement is accurate under penalty of perjury.
The undersigned, submitting this bid, hereby agrees with all the terms, conditions, and specifications
required by [COMPANY] in this Request for Proposal and declares that the attached bid and pricing are
in conformity therewith.
___________________________________________________________
Signature Title
___________________________________________________________
Name (type or print) Date
