Laserfiche WebLink
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 South Bend <br />`�111111111///� Ix' <br />�.'N 'Oactors � <br />`an •.... ti0 is B <br />.• ... <br />Y <br />r �vaRATE <br />_ ..• 5EA _ <br />STATE OF Indiana _ J <br />) ss <br />COUNTY OF St. Joseph ) <br />day of March , 2022 <br />North, Inc. <br />—fmkne of Organization) <br />in F. Hilary <br />_ Director of Estimating <br />(Title of Person S1gning) <br />ACKNOWLEDGEMENT <br />Before me, a Notary Public, personally appeared the above-named Dustin P. Hilgry <br />swore that the statements contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this 22nd <br />My Commission Expires:_ 6/5/22 <br />County of Residence: St.Josenh <br />day of March _ , 2022 <br />and <br />r- <br />i - <br />l-tzg � <br />hofary Pul Alisha Krueger <br />ALISHA KRUEGER <br />'�T -. <br />La Porte County <br />s " <br />My Commission Expires <br />June 5, 2022 <br />