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RETURN WITH BID <br /> NON-COLLUSION AFFIDAVIT <br /> STATE OF ��k L_ <br /> COtJNTY OF <br /> being first duly sworn, <br /> deposes and says that they are A(�2_ A- <br /> (sole owner, partner, president, <br /> secretary, etc.) of L— vi, –,.F4he party making the foregoing <br /> bid;that such bid is not made in the interest of or on behalf of ark undisclosed person,partnership, <br /> company, association, organization or corporation; that such bid is genuine and not collusive or <br /> sham; that said bidder has not directly or indirectly induced or solicited any other bidder to put in <br /> a false or sham bid,and has not directly or indirectly colluded, conspired,connived, or agreed with <br /> any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding;that said <br /> bidder has not in any manner, directly or indirectly, sought by agreement, communication or <br /> conference with anyone to fix the bid price of said bidder or of any other bidder, or to fix any <br /> overhead, profit or cost element of such bid price, or of that of any other bidder, or to secure any <br /> advantage against the public body awarding the contract or anyone interested in the proposed <br /> contract; that all statements contained in such bid are true; and, further, that said bidder has not, <br /> directly or indirectly, submitted their bid price or any breakdown thereof, or the contents thereof, <br /> or divulged information or data relative thereto, or paid and will not pay any fee in connection <br /> therewith to any corporation, partnership, company, association, organization, bid depository, or <br /> to any member or agent thereof,or to any other individual except to such person or persons as have <br /> a partnership or other financial interest with said bidder in their general business. <br /> Signed: <br /> r , F <br /> Subscribed and sworn to before me this day of , 2023. <br /> (SEAL) OFFICIAL SEA" <br /> KAREN' S ROHMAN Notary Public <br /> NOTARY PUBLIC,STATE OF ILLINOIS <br /> Expires 06-15-2025 <br /> *The Own4f- any award 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 /> 1 <br /> 1 <br /> 28 <br />