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NON-COLLUSION AFFIDAVIT <br /> ' RETURN WITH BID <br /> ' STATE OF Indiana <br /> ) ss <br /> COUNTY OF Randolph ) <br /> Doreen M. Culy being first duly sworn, <br /> deposes and says that they are President (sole owner, partner, president, <br /> secretary, etc.) of Culy Contracting LLC , the party making the <br /> foregoing bid; that such bid is not made in the interest of or on 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 /> 1 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 /> ' <br /> __led: <br /> ed: <br /> n� <br /> J --�v(_'tLL_ <br /> T'tle re dent <br /> Subscribed and sworn to before me this 22nd day of September 92021. <br /> (S PRv p&�/ STEPHEN HINKLE,Notary PublicA 10 <br /> S AL * Randolph County,State of Indiana 7otary Public <br /> ''vo1ANP My Commission Expires December 9,2022 <br /> ' *The Owner reserves the right, before 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 /> 26 <br />