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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 />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 6`s / gay of <br />me of Organization) <br />KEL(y ®�® <br />r .• B <br />• ° �4ORAi n <br />= .�® Dustin Hilary, Area Manager <br />(Title of Person Signing) <br />i •°�ND4P°°ACKNOWLEDGEMENT <br />�',110111 � ti �� <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 6tt' day of July, 2017. <br />J) -if LA <br />Alisha <br />�_ A <br />eger, Notary Public <br />My Commission Expires: June 5, 2022 <br />AL.iSHA KFiU7GER <br />County of Residence: St. Joseph .��gP�Y•AUs'-r Notary Dubuc, State of Indiana <br />Z. r;So.. <br />'L'O° <br />EA <br />hCountY <br />St,Josap <br />~'%'NniA�P��� <br />My Commission Expires <br />Juna06.2022 <br />