Section II: Who is your Report About?

Business Information
Name of Business*
Address
City
State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming    Zip
Telephone
Website or Email
Product or Service

Section III: What Did You Notice?

Answer "yes" or "no;" then describe in detail.
What amount of money is involved?	$
Is there evidence that two or more competing sellers of similar products agreed to:    Price their products a certain way,    Sell only a certain amount of their product, or    Sell only in certain areas or to certain customers?	Yes      No
Are there large price changes involving more than one seller of very similar products of different brands, (particularly if the price changes are of an equal amount and occur at about the same time)?	Yes      No
Are there suspicious statements from a seller suggesting that only one firm can sell to a particular customer or type of customer?	Yes      No
Have fewer competitors than normal submitted bids on a project?	Yes      No
Have competitors submitted identical bids on a project?	Yes      No
Has the same company repeatedly been the low bidder on contracts for a certain product or service or in a particular area?	Yes      No
Do bidders seem to win bids on a fixed rotation?	Yes      No
Is there is an unusual and unexplainable large dollar difference between the winning bid and all other bids on particular projects?	Yes      No
Does the same bidder bid substantially higher on some bids than on others, and there is no logical cost reason to explain the difference?	Yes      No
Provide additional detail here, including points not suggested above. Describe events in the order that they happened:

Section IV: Follow Up

OAG Review

Have you shared your complaints with a supervisor or other work colleague or a law enforcement agency? Do you want us to speak with the supervisor or work colleague?     Yes     No  If yes, provide names and contact information for them.

By submitting this information, I hereby attest to the accuracy or truthfulness of the content.   Yes     No  Date*        Signature*  (Please type your name) To review the information before you submit, or to print a copy for your records, select View Printable Form, then select the print icon from the browser window.

Office of the Attorney General
Government of the District of Columbia
441 4th Street, NW, Suite 450 North
Washington, DC 20001
(202) 442-9828 (consumer hotline)
Fax: (202) 727-6546

 

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