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SECTION III CONTRACTOR'S FINANCIAL STATEMENT <br />Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required <br />by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding <br />the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's <br />capability for completing the project if awarded. <br />SECTION IV CONTRACTOR'S NON -COLLUSION AFFIDAVIT <br />The undersigned bidder or agent, being duly sworn on oath, says that he has not, nor has any other member, <br />representative, or agent of the firm, company, corporation or partnership represented by him, entered into any <br />combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to <br />prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference <br />to any other bid and without any agreement, understanding or combination with any other person in reference to such <br />bidding. <br />He further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, <br />fee, gift, commission or thing of value on account of such sale <br />SECTION V OATH AND AFFIRMATION <br />I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION <br />CONTAINED IN THE FOREGOING BID FOR PRBLIC WORKS ARE TRUE AND CORRECT. <br />Dated at South Bend this 23ra / ay of ...M...ay,,2017. <br />����taeiliar <br />& KE<< °�i W (sh ell . <br />Co .•,••'.,., X oi�, ame of O ization) <br />G()UORATE :,0 a B <br />•, A <br />r <br />•�� �7L'i Ci�ad' __. Dustin Hilary, Area Manager <br />�is� ••., e® (Title of Person Signing) <br />P o' <br />� 1111t OWLEDGEMENT <br />STATE OF Indiana <br />ss <br />COUNTY OF St. Joseph <br />Before me, a Notary Public, personally appeared the above -named Dustin Hilary and <br />swore that the statements contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this 23ra day of MLay, 2017. <br />tsha Krueger, Notary Pul6 <br />My Commission Expires: June 5 2022 <br />ALiSWA KRUEGEFI <br />County of Residence: St. Joseph <br />n cDun,yndiane <br /><, <br />tit�! OJT. ,J03ft(3 <br />'�. ••LL LSL �a`� Y C0r1JMl5S;00 E.xPifes <br />.June 05, 202,1..i <br />ry+1gi111��� . <br />