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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 combination, <br />collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person <br />from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and <br />without any agreement, understanding or combination with any other 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 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 <br />%,,r a c for �� V nt <br />RgTF..0 <br />s0�_ <br />SEAL <br />11b Nbl ON` <br />nnnt <br />this 131h _ day of <br />ACKNOWLEDGEMENT <br />STATE OF Indiana 1 <br />ss <br />COUNTY OF St. Joseph <br />of Organization) <br />(Title of Person Signing) <br />Before me, a Notary Public, personally appeared the above -named Dustin Hilary and <br />swore that the statements contained in the foregoing document are true and correct. <br />Area <br />Subscribed and sworn to before me this 13th day of April,. 2021. <br />lisha Krueger, Notary Pu <br />My Commission Expires: June 5, 2022 _ \011111 A L I S H A K R U E G E R <br />Y'AV9r,G Notary Public. state of Indians <br />County of Residence: St. Joseph=2.SEAL, —E St. Joseph county <br />My Commission Expires <br />June05,2022 <br />