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 ASE TRUE AND CORRECT. <br />Dated at <br />n <br />0 RATIC S <br />v: <br />�'••, SEAL <br />''' bN V 1 aN`������``` <br />o1rtnn��o <br />STATE OF Indiana <br />COUNTY OF St. Joseph <br />South Bend this <br />Milestone �' <br />day of October 2022 <br />h, Inc. <br />BY. <br />_Du h P. Hilary, Director of Estimating _ <br />(Title of Person Signing) <br />ACKNOWLEDGEMENT <br />) ss <br />Before me, a Notary Public, personally appeared the above-named Dustin P. Hi <br />swore that the statements contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this 25th <br />My Commission Expires: -June 5, 2030 <br />County of Residence: LaPorte <br />day of _ October 2022 <br />Notary Publc r <br />and <br />'J <br />?o !�; ? a% <br />ALISHA KRUEGER <br />M.SEALCwvyisslon e= <br />J20 PM <br />Commission Num&; NM <br />53544 <br />U Porte counb <br />