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NON-COLLUSION AFFIDAVIT
<br /> �
<br /> � RETURN WITH BID
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<br /> STATE OF —j-L—
<br /> COUNTY OF �1+��-���
<br /> �4�A�D ��. 4-�LLn_,�--� , being first duly sworn,
<br /> deposes and says that they are j�-�,��-j-ti r��,� (sole owner, partner, president,
<br /> ) � � �. the party making the
<br /> secretary, etc. of �p �p��r,� �c,�G:,a � �:� ,
<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: ,��4.9�.,, I
<br /> Tit il
<br /> �� � I
<br /> -i e s t e r e this �� — day of � �. ���i' , 2015.
<br /> OFFICIAI SEAL �—,
<br /> (SE NATHAN D HALE � _
<br /> �OTARY PUBLIC, STATE OF ILLINOIS Nota� Public
<br /> My Commission Expires Feb 23, 2019 �'
<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.
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