Mississippi Administrative Code
Title 12 - Finance and Administration
Part 9 - Office of Personal Service Contract Review Rules and Regulations
Chapter 6 - REQUESTS FOR PROPOSALS AND REQUESTS FOR QUALIFICATIONS
Exhibit 12-9-6-3 - Sample Post Evaluation Affidavit

1. My name is [Name]. I am above the age of legal majority and am a resident of the State of Mississippi. I am of sound mind and judgment and suffer no legal disabilities. I have personal knowledge of all statements herein.

2. From [Start Date] to [End Date], I participated as a(n) [procurement officer, evaluator, advisor] in the procurement process in which [Agency Name] issued a Request for [Proposals, Qualifications], RFx Number [1234567890] seeking [Services].

3. I participated in the procurement process described in Paragraph 2 in good faith. At all relevant times, I acted with integrity. I was not motivated by bias for or against any particular offeror, any other unethical consideration, or by achieving a specific outcome from the procurement.

4. My participation in the process was limited to [evaluating, advising] the [proposals, qualifications] received in response to the solicitation described in Paragraph 2 solely on the criteria stated in the Request for [Proposals, Qualifications]. I did not consider factors outside of the criteria stated in the Request for [Proposals, Qualifications] when [evaluating, advising].

5. I have reviewed the final calculation of points awarded and have determined the final scores are a true and correct representation of the evaluation committee's collective assessment of the [proposals, qualifications] received in response to the solicitation described in Paragraph 2.

6. I understand that the goal of the procurement process is to obtain best value for [Agency Name] in a competitive, fair, and transparent process. It is my belief that the intended awardee's [proposal, qualification] represents the best value for [Agency] based on the criteria in the Request for [Proposals, Qualifications].

7. I have reviewed the Mississippi Ethics in Government laws, Mississippi Code Annotated §§ 25-4-101 through 25-4-121, and am not in violation of such laws with regard to my participation in procurement process described in Paragraph 2.

8. I have no personal knowledge that any other participant in the procurement process described in Paragraph 2 acted in violation of the Mississippi Ethics in Government laws or otherwise acted with dishonesty, bias, or other unethical conduct.

Under penalty of perjury, I declare that, to the best of my knowledge and belief, the information contained herein is true, correct, and complete.

[SIGNATURE BLOCK FOR NOTARY] [SIGNATURE BLOCK FOR AFFIANT]

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