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NON COLLUSION AFFIDAVIT OF PRIME BIDDER <br /> STATE OF till t S ) <br /> ) SS. <br /> COUNTY OF ) <br /> -DAV O W. 'yPeLs'i" ,BEINGFIRST DULY <br /> SWORN,says that: <br /> 1) He is (Owner, Panner, Offs Representative, or Agent) of <br /> Pthe Bidder that bas submitted the <br /> attached bid; <br /> 2) He is fully informed respecting the preparation and contents of the attached bid and <br /> of all pertinent circumstances respecting such bid; <br /> 3) Such bid is genuine and isnot a collusive or sham bid; <br /> 4) Neither the said bidder nor any of its officers, partners, owners, agents, A <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 wbich the attached bid has <br /> been submitted or to refrain from bidding in connectionvA&such contract;Or has in anymam", <br /> directly or indirectly, sought by agreement, or collusion or communication or conference with <br /> auy 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 tbrough a collusion, conspiracy, connivance or unlawful agreement any <br /> advantage against the City of Decatur,Illinois,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 tabited <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 iu inter including this affiant. <br /> Title <br /> Subsc riibed and sworn to before me ibis Z day of ��r <br /> 201 <br /> o lb c <br /> we <br /> My Commission expires tuj27l�b�l <br /> "OFFICIALSEAL" <br /> TIFFANY C CRAW <br /> NOTARY PUBLIC,STATE OF ILLINOIS <br /> MY COMMISSION EXPIRES 06.2A•2023 <br />