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NON-COLLUSION AFFIDAVIT <br /> STATE OF I LLI tgol S <br /> COUNTY OF NkG►.ITC 1 d1 C C}1 <br /> RETURN WITH BID <br /> (O l Li AM L b"n.1£--I being first duly sworn, <br /> deposes and says that they are 5 I rJE�• -r (sole owner, partner,president, <br /> secretary, etc.) of Li ki o6i I oc , 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 /> Signed: <br /> Title ►'� �� -ter <br /> Subscribed and sworn to before me this 3 day of 92014. <br /> (SEAL) <br /> otary Public <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 /> OFFICIAL SEAL <br /> NANCY DAVENPORT <br /> NOTARY PUBLIC,STATE OF UJINOIS <br /> 16 MY C a=iWm 0&21-17 <br />