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NON-COLLUSION AFFIDAVIT <br /> RETURN WITH BID <br /> STATE OF Ll. !J D(— <br /> COUNTY OF A&�,,C-JN <br /> being first duly sworn, <br /> deposes and says that they are I baK (sole owner, partner, president, <br /> secretary, etc.) ofDkINO eftpA.0j, " the party making the <br /> foregoing bid; that such bid is not mad in the interest of orton behalf of any undisclosed person, <br /> partnership, company, association, organization or corporation; that such bid is genuine and not <br /> collusive or sham; that said bidder has not directly or indirectly induced or solicited any other <br /> bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, <br /> connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall <br /> refrain from bidding; that said bidder has not in any manner, directly or indirectly, sought by <br /> agreement, communication or conference with anyone to fix the bid price of said bidder or of <br /> any other bidder, or to fix any overhead, profit or cost element of such bid price, or of that of any <br /> other bidder, or to secure any advantage against the public body awarding the contract or anyone <br /> interested in the proposed contract; that all statements contained in such bid are true; and, <br /> further,that said bidder has not, directly or indirectly, submitted their bid price or any breakdown <br /> thereof, or the contents thereof, or divulged information or data relative thereto, or paid and will <br /> not pay any fee in connection therewith to any corporation, partnership, company, association, <br /> organization, bid depository, or to any member or agent thereof, or to any other individual except <br /> to such person or persons as have a partnership or other financial interest with said bidder in their <br /> general business. <br /> Signed: <br /> da;fA 7�01h. <br /> 4L-,fj Title IbWT <br /> ry <br /> Subscribed and sworn to before me this ��'y of , 2021. <br /> (SEAL) <br /> " <br /> OFFICIAL SEAL" Notary P is <br /> IFFANY C CRAW <br /> PUBLIC,STATE OF ILLINOIS <br /> ISSION EXPIRES 06.24.2023 <br /> *The Owng Deore any award of contract is made,to require of any bidder to <br /> whom it may make an,award of the Contract, a duly executed non-collusion affidavit in the form <br /> designated above. <br /> 28 <br />