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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 />1 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 Sou h Bend —this 2Ath - day of August 2021 <br />MilestonjeCWitraqMrs North, Inc. <br />oN, tactors ,�'.*A of Organization) <br />��• , ......, Nor �� a/ <br />��� `o; • • e ;i By — <br />yr : ORATE ••••� <br />c • �Q : 3 ' in P. Hilary <br />Director of Estimating_ <br />(Title of Person Signing) <br />i� !?, • `� <br />ACKNOWLEDGEMENT <br />STATE OF Indian } <br />) ss <br />COUNTY OF St. Joseoh } <br />Before me, a Notary Public, personally appeared the above-named Dustin P. Hilary <br />swore that the statements contained in the foregoing document are true and correct. <br />and <br />Subscribed and sworn to before me this 24th day of August <br />J_W,eyPubfi�Alis6i_K_rueger <br />My Commission Expires: 6/5/22 <br />County of Residence:. St.Joseph <br />tPaO,S s , ALISHA KRUEGER <br />j nrouwv .: La Porte County <br />My Commission Expires <br />June 5, 2022 <br />