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i 7 I <br /> ' NON-COLLUSION AFFIDAVIT <br /> ' I <br /> STATE OF ILLINOIS <br /> ' ss <br /> COUNTY OF EDGAR ) <br /> ' RETURN WITH BID <br /> John S. Blair <br /> being first duly sworn, <br /> deposes and says that they are Chairman / CEO (sole owner,partner, president, <br /> secretary, etc.) of Feutz Contractors, Inc. , 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 a an fee in connection therewith to an corporation, partnership, company, association <br /> Y � p� > <br /> P Y Y � P <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 /> tSigned: <br /> ' Title <br /> ' Subscribed and sworn to before me this 5th day of .11,nP , 2013. <br /> ++ee•eeeeo••••eeee•ee•etee ` <br /> ' (SEAL) "OFFICIAL.;F.M." <br /> CAROLS S. HOLLINCSWORTH Notary Public <br /> Notary Nshli- Statr of 11linois <br /> My Commissio::Fxl; X2.19-14 3 <br /> gs•eeeeeoe•esoeeeeee+ecce <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 /> Y � Y <br /> designated above. <br /> 1 <br /> 19 <br />