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' NON-COLLUSION AFFIDAVIT
<br /> ' STATE OF ILLINOIS
<br /> COUNTY OF MACON
<br /> RETURN WITH BID
<br /> &3a7- E, (,INN being first duly sworn,
<br /> deposes and says that they are c 7Fc_&g (sole owner,partner,president,
<br /> secretary, etc.) of aAaN coryi;W N , 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 /> 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 /> Si 2(j 5,L-
<br /> ,40664T6,
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<br /> ,20654T6, QU*Title �. C_49-Mt N
<br /> Subscribed and sworn to before me this `C day of JruwE , 2014.
<br /> ' (SEAL) "OFFICIAL SEAL"
<br /> SETH C GARREN
<br /> NOTARY PUBLIC,STATE OF ILLINOIS Notary Public
<br /> ' MY COMMISSION EXPIRES 03.16.3017
<br /> *The Owner reserves t e 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.
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