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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 partnership 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 THATTHE FACTS AND INFORMATION <br />CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE'TRUE AND CORRECT. <br />Dated at South Bend, In._ —this <br />fietley <br />By..........f:� <br />STATE OF Iiiarw <br />COUNTY OF St. Josep ss...�� <br />22nd day of October 2019 <br />Construction Co,, Inc. <br />777777:77iWame of On <br />ACKNOWLEDGEMENT <br />'"Sales Manager <br />of polson drxa� i"(1) <br />Before me, a Notary Public, personally appeared the above -named Joshua A. McCormick and <br />swore that the statements contained In the foregoing document are true and correct. <br />Subscribed and sworn to before me this 22nd day pternber 19 <br />_. _ . . <br />Dawn E. Armst f "to'' PU64 <br />My Commission Expires: 4/18/23 <br />County of Residence: LaPorte <br />«,H�'^`°° i�`Wi' t W,i"It`°`i"iG <br />�B�i��a:�9ya��.t�,„Phr aR4F&aro�r�8�iraSi�+.��ofFiV <br />,� rgorrH � ILtu��ruar��r� at��auut�� <br />qd9 <br />°a owe Nt R�umxu�"a"rov <br />My C+�'.pw09i1rw6 rSkW„�fs 9 ir�nG%P@�„ <br />��p 1 <br />J�" U�YJI^�°nie oulll?e7Asnv.r�yydBUllld Y1D m1���liSrtif�+lry!gOaP�WYl�mU7,Mm9 ✓�'fAl v+➢2t17+�&YL`��':ve <br />