|
'� NON-COLLUSION AFFIDAVIT
<br /> RETURN WITH EID
<br /> �`
<br /> � STATE OF �llinois �
<br /> ) ss
<br /> COUNTY OF �con �
<br /> ,
<br /> ,
<br /> Jeffrey S. Burdick , being first duly sworn,
<br /> ' deposes and says that they are vice—President (sole owner, partner, president,
<br /> secretary, etc.) of Burdick Plumbing � Heating Co., 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 ar 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 I
<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 /> '
<br /> � Signed:
<br /> _ _�
<br /> . '
<br /> `� Tit e
<br /> � Jeffrey S. Burdick, Vice—President
<br /> � Subscribed and swot t��� r me this 22 day of �e , 2016.
<br /> OFFICIAL SEAL
<br /> (S AL) LESLIE B. CASSITY
<br /> NOTARY PUBLIC,STA7E OF ILLINOIS Notary Pub c
<br /> � My Commissi�n ExpiresApril 03,2020 Lesl' . Cassity
<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 /> �
<br /> ' �
<br /> Z7
<br />
|