PSA - Olive Street Road Reconstruction Inspection Project - HWC Engineering

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Version 6-8-2017 Non -Collusion. The undersigned attests, subject to the penalties for perjury, that he/she is the CONSULTANT, or that he/she is the properly authorized representative, agent, member or officer of the CONSULTANT, that he/she has not, nor has any other member, employee, representative, agent or officer of the CONSULTANT, directly or indirectly, to the best of his/her knowledge, entered into or offered to enter into any combination, collusion or agreement to receive or pay, and that he/she has not received or paid, any sum of money or other consideration for the execution of this Contract other than that which appears upon the face of this Contract. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC §4-2-6-1, has a financial interest in the Contract, the Party attests to compliance with the disclosure requirements in IC §4-2-6-10.5. In Witness Whereof, the CONSULTANT and the LPA have, through duly authorized representatives, entered into this Contract. The parties having read and understand the forgoing terms of this Contract do by their respective signatures dated below hereby agree to the terms thereof. CONSULTANT HWC Engineering AF6 Signature _ _ .e Terry Baker, President (Print ortypename and title) Attu.. i tatu, James S. Rice, PE, Partner (Print or type name and title) 17 LOCAL PUBLIC AGENCY Board of Public Works Signature Gary A. Gilot, President (Print or type name and title) Signature Laura O'Sullivan, Member (Print or type name and title) Signature Genevieve E. Miller, Member a.(Pr°irtt tsar ype name and title) _._ O. ................. Signature Elizabeth A. Maradik, Member .. . -- ----—....._ ............................... (Print or type name and title) -rhetese- I 00CAA/ /Aer» be