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' NON-COLLUSION AFFIDAVIT <br /> n <br /> ' STATE OF •i70 <br /> ) ss / <br /> COUNTY OF ` e <br /> RETURN WITH BID <br /> r! being first duly sworn, <br /> deposes and says that the are (sole owner,partner,president, <br /> secretary, etc.) of the parry making the <br /> ' foregoing bid; that such bid is t 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 /> 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 /> a <br /> 1j; <br /> / <br /> ' ,'CS VTitle <br /> 24 <br /> Subscribed and sworn to before me this 741-day of A vre,"i _' 2023. <br /> (SEAL) �1.7L <br />' Notary blic <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 />' 19 <br />