Laserfiche WebLink
NON-COLLUSION AFFIDAVIT <br /> STATE OF T L <br /> COUNTY OF C�✓� <br /> RETURN WITH BID <br /> `C -4 �--Q-� i , being first duly sworn, <br /> deposes and says that the (sole owner,partner,president, <br /> secretary, etc.) ofthe party making the <br /> foregoing bid;that such bid is not made in the interest ofon behalf of any undisclosed person, <br /> partnership, company, association, organization or corpor ion; 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 /> itle <br /> Subs t is ✓l day of _ ' \ , 2014. <br /> "OFFICIAL SEAL" <br /> (SEAL) KAREN 3 ROHIMAN (�( <br /> NOTARY►Wuc,STATE OF LLINOR Notary Public <br /> MY COMMIStlow EXMIt"96.16.3111 <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 /> 14 <br />