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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 <br />of April, 201 <br />ame <br />Dustin Hilary, South Bend Area Manager <br />(Title of Person Signing) <br />ACKNOWLEDGEMENT <br />STATE OF Indiana ) <br />ss <br />COUNTY OF St. Jose h <br />Before me, a Notary Public, personally appeared the above -named Dustin Hilary_ -and swore that the statements <br />contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this <br />My Commission Expires: June S, 2022 __ <br />County of Residence: St. Joseph <br />KRUEGER <br />°,,111111l,i,, ALISHA <br />Notary Public, State of Indiana <br />�a`gPRY•�.UB�% <br />_ 'SEAV° <br />St.J-e ph County <br />Expires <br />* ,, <br />♦�y Commission <br />Juna0b 2022 <br />1�/11111111�\` <br />