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NON-COLLUSION AFFIDAVIT OF PRIME BIDDER <br /> STATE OF �l ►J0( S ) <br /> ) SS. <br /> COUNTY OF �7 ) <br /> ),sL ` 'V(L�t_.'{' ,BEING FIRST DULY <br /> SWORN,says that: <br /> 1) He is (Owner, Partner, O:ffic_er, Representative, or Agent) of <br /> p�f C?t ,i t St fl the Bidder that has submitted the <br /> attached bid; tY 114 , kN t <br /> 2) He is fully infonned respecting the preparation and contents of the attached bid and <br /> of all pertinent circumstances respecting such bid;- <br /> 3) <br /> id;3) Such bid is genuine and is not a collusive or sham bid; <br /> 4) Neither the said bidder nor any of its officers, partners, owners, agents, <br /> representatives, employees or parties in interest,including this affiant,has in any way colluded, <br /> conspired, connived or agreed, directly or indirectly, with any other bidder, firm or person to <br /> submit a collusive or sham bid in connection with the contract for which the attached bid has <br /> been submitted or to refrain from bidding in connection with such contract,or has in any manner, <br /> directly or indirectly, sought by agreement, or collusion or communication or conference with <br /> any other bidder,firm or person to fix the price or prices in the attached bid or of any other <br /> bidder,or to fix any overhead,profit or cost element of the bid price or the bid price of any other <br /> bidder, or to secure through a collusion, conspiracy, connivance or unlawful agreement any <br /> advantage against the City of Decatur,Minois,or any person interested in the proposed contract; <br /> and <br /> 5) The price or prices quoted in the attached bid are fair and proper and are not tainted <br /> by any collusion,conspiracy,connivance or unlawful agreement on the part of the bidder or any <br /> of its agents,representatives,owners,employees,or parties in interest,including this affiant. <br /> Tithe <br /> ubscr1ibed and sworn to before me this day of <br /> 207, - N i <br /> "ablin <br /> Title <br /> My commission expires � � �3 FICIAL SEAL" <br /> TIFFANY C CRAW <br /> NOTARY PUBLIC,STATE OF ILLINOIS <br /> MY COMMISSION EXPIRES 06.24.2023 <br /> 16 <br />