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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 <br />member, representative, or agent of the firm, company, corporation or p-artnership represented by him, entered <br />into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such <br />letting nor to prevent any person from bidding nor to include anyone to refrain from bidding, and that this bid is <br />made without reference to any other bid and without any agreement, understanding or combination with any other <br />person in reference to such bidding. <br />He further says that no person or persons, firms, or corporation: has, have or will receive directly or <br />Indirectly, any rebate, 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 PUBLIC WORKS ARE TRUE AND CORRECT. <br />Dated at ^mmPlymouth Indiana <br />By <br />this 5th day of, December <br />iana Contracting, Inc. <br />I , /I I (Name of Organization) <br />Scott Kirkpatrick, President <br />(Title of Person Signing) <br />FTATQIIZi �k �k I <br />9" <br />STATE OF Indiana <br />COUNTY OF Marshall )ss <br />Before me, a Notary Public, personally appeared the above -named Scott Kirkpatrick <br />and <br />swore that the statements contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this 1 9th day of December 2017 <br />Notary public <br />My Commission Expires:_192-0—tQ_ <br />County of Residence: Marshall <br />