This document is a statement that must be signed by a bidder in order for their bid to be considered for award. The statement acknowledges that the bidder understands the consequences of providing false information or engaging in fraudulent activities, including fines, imprisonment, and civil damages. Failure to sign the statement will result in the bid being considered non-responsive and disqualified from being awarded. The document also includes spaces for the bidder's signature, date, and the name of their company.