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' NON-COLLUSION AFFIDAVIT <br /> tSTATE OF <br /> ) ss <br /> ' COUNTY OF <br /> ' RETURN WITH BID <br /> = � �--Z,/ , being first duly sworn, <br /> deposes and says that they a (sole owner, partner, president, <br /> secretary, etc.) of -e( ��,(c� �,TL the party making the <br /> ' foregoing bid; that such bid is not made in the interest f 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 /> ' Title <br /> Subscribed and sworn to before me this q-1G( day of 52014. <br /> ' "OFFICIAL SEAL" <br /> (SEAL) KAREN S ROHMAN <br /> ' <br /> F- w;Y-COMMISSION <br /> OTARY PUBLIC,STATE OF ILLINOIS Notary Public <br /> EXPIRES 04.16-2017 <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 /> 17 <br />