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<br /> ' NON-COLLUSION AFFIDAVIT
<br /> RETURN WITH BID
<br /> ISTATE OF �l G ) ���5 )
<br /> COUNTY OF ) SS��K )
<br /> '
<br /> '
<br /> ' ����� ��Ll-- , being first duly sworn,
<br /> deposes and says that they are ��ET�y (sole owner, partner, president,
<br /> ' secretary, etc.) of /�1 /AWES��/�/CE L02�o2r4-T/o�J , 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 /> � �-
<br /> � � � �
<br /> � ��,�_�� �
<br /> i e �:�G�ETf��/
<br /> /
<br /> rti
<br /> Subscribed and sworn to before me this�day of �f�f''��f , 2016.
<br /> �sEaL� �o�icu�s�• �" � -��':�-� � �<���� ��
<br /> � ELIZABETH WATSON
<br /> Nofary rublk,stare o�nu�oi. Notary Public ,
<br /> My Commipion E�ira hms Y5,201 b �
<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 /> ' I
<br /> �
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