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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 I Ith y of July, 2017. <br />I; 're Wal ell <br />®� / fr <br />••. s ame o - rganization) <br />z_V 'O <br />' QORATFm.C' <br />• C <br />BZ// <br />°�,.' �• a /L--Pustin Hilary, Area Manager <br />'o •••..._•••' �' (Title of Person Signing) <br />1ND11�N� <br />)t��OWLEDGEMENT <br />STATE OF Indiana ) <br />) ss <br />COUNTY OF St. Joseph ) <br />Before me, a Notary Public, personally appeared the above -named Dustin Hilar Viand <br />swore that the statements contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this 11'h day of Jul,,. <br />'Alisha Krueger, Notary Pu is <br />My Commission Expires: June 5, 2022 A!_ I S H A K R tJ is G E hi '`�p5UlFripr�'i <br />�0� Notary Public. state of Indians <br />County of Residence: St. Joseph it SEAL, St. Joseph county <br />*` my commission Expires <br />'•'rnrnu,o June 05.2022 <br />