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NON-COLLUSION AFFIDAVIT <br /> STATE OF ILLINOIS <br /> r.� COUNTY OF MACON <br /> RETURN WITH BID <br /> James P. Bruner being first duly sworn, <br /> deposes and says that they are President (sole owner,partner,president, <br /> r <br /> secretary, etc.) of l V ,11DAI 11�WWCNWMMk1K the party making the <br /> foregoing bid;that such bid is not made in the interest of or on behalf of an undisclosed person <br /> ,- <br /> partnership, <br /> g Y P <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 depositary,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 /> f , <br /> Signed: <br /> _ i r <br /> President <br /> Title <br /> Subscribed and sworn to before me this day of A ' 2013. <br /> OFFICIAL SEAL / <br /> (SEAL) RKMARD K.FERNANDES,JR. <br /> HOMY PU M,STATE OF ILLINOIS of Public <br /> W 00WASSItNI EXPIRES 1.2-2015 ' <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 />