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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 THAT THE FACTS AND INFORMATION <br />CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT. <br />Dated at <br />STATE OF Indiana <br />COUNTY OF St. Joseph <br />South Bend this <br />26th day of _ October 2021 <br />TGB Unlimited <br />(Name of Organization) <br />By <br />Vice President of Operations <br />(Title of Person Signing) <br />ACKNOWLEDGEMENT <br />Before me, a Notary Public, personally appeared the above-named <br />Gene Mann and <br />swore that the statements contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this 26th day of O 2021 <br />N ryu is <br />TI <br />LYNN s ate <br />Bot Indiai <br />June 18, 2023 ���PPY•P���' Notery Pubilc, <br />My Commission Expires: 4�g Laporte County <br />commission Expires <br />County of Residence: LaPorte�''No AQP My June 18. 2113 <br />:. <br />