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SECTION IV CONTRACTOR'S NON — COLLUSION AFFIDAVIT <br />The undersigned bidder or agent, being duly swom 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 THAT THE FACTS AND INFORMATION <br />CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT. <br />Dated at South Bend <br />this 8th day of June 2021 <br />,��111111// <br />Milestone Con G rs <br />County of Residence: LaPorte _ <br />(Neme�ofOrg8afzdtion) <br />•e <br />tom. J <br />3 e RR�.. 3 = <br />Dustin P Hilary <br />Director of_Estimatin_ j South Ben <br />• S Y • <br />(7 Itle of Person Signing) <br />N <br />`N %%N <br />0',,, <br />ACKNOWLEDGEMENT <br />STATE OF Indiana } <br />ss <br />COUNTY OF St. Joseph <br />Before me, a Notary Public, personally appeared the above-named Dustin P. Hilary and <br />swore that the statements contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this 8th day of June 2021 <br />Notary Publia Alisha Krueger <br />My Commission Expires:_ 6/5/22 <br />coy"�e4� ALISHAKRUEGER <br />County of Residence: LaPorte _ <br />_'"°T"�"':. La Porte County <br />a..s My Commission Expires <br />'�rFoc rp:' <br />June 5, 2022 <br />