|
NON-COLLUSION AFFIDAVIT
<br /> STATE OF K.I n rV_&0+*_ )
<br /> COUNTY OF UISVI i h )
<br /> RETURN WITH BID
<br /> 1
<br /> ' Robb Johnson being fir t duly sworn, deposes
<br /> and says that they are "t sole owner, p r, president, secretary,
<br /> etc.) of e�p'arty making the foregoing bid; that such
<br /> ' bid is not Ade in interest of or on behalf of any undisclosed person partnership, company,
<br /> association, organization or corporation; that such bid is genuine and not col sive or sham; that said
<br /> bidder has not directly or indirectly induced or solicited any other bidder to p t in a false or sham bid,
<br /> ' and has not directly or indirectly colluded, conspired, connived, or agreed w any bidder or anyone
<br /> else to put in a sham bid, or that anyone shall refrain from bidding; that sa d bidder has not in any
<br /> manner, directly or indirectly, sought by agreement, communication or confe nce with anyone to fix
<br /> ' the bid price of said bidder or of any other bidder, or to fix any overhead, I irofit or cost element of
<br /> such bid price, or of that of any other bidder, or to secure any advantage igainst the public body
<br /> ' awarding the contract or anyone interested in the proposed contract; that all statements contained in
<br /> such bid are true; and, further,that said bidder has not, directly or indirectly, ubmitted their bid price
<br /> or any breakdown thereof, or the contents thereof, or divulged information oi data relative thereto, or
<br /> ' paid and will not pay any fee in connection therewith to any corporation, partnership, company,
<br /> association, organization, bid -depository, or to any member or agent tt ereof, or to any other
<br /> individual except to such person or persons as have a partnership or other fir ancial interest.with said
<br /> ' bidder in their general business
<br /> tSigned:
<br /> JenniferS. Hummelf
<br /> ' Notary Public
<br /> Minnesota Title
<br /> --r;;,,,,,,,..•'`yy� ,�„s,y 31,2015
<br /> ' Subscribed and sworn to before me this v744 day of , 2013.
<br /> ' (SEAL)
<br /> 1—Notary 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-collus' n affidavit in the form
<br /> designated above.
<br /> 1
<br /> ' 16
<br />
|