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 LaPorte, IN this 22nd day of October 2024 <br />Larson -Danielson Construction Co., Inc. <br />me of Organization) <br />LARSON-DANIELSON <br />By X F CONSTRUCTION CO., INC. <br />Brian T. Larson, President <br />(Title of Person Signing) <br />ACKNOWLEDGEMENT <br />STATE OF Indiana <br />ss <br />COUNTY OF LaPorte <br />Before me, a Notary Public, personally appeared the above -named Brian T. Larson and <br />swore that the statements contained in the foregoing document are true and correct. <br />Subscribed and sworn to before me this 22nd day of October 2024 <br />Digitally signed by Michele Dzielinski <br />DN: C=US, E="nncd@ldconstruction,. nn", <br />x Michele Dzielinski Date Michele Dzielinski <br />2024.10.22 753:32-05'00' <br />Notary Public <br />"Pv„ �., MN:NFLE LECELMD2IELINSNI <br />' 'x= MYCmmise0 2031 <br />Michele C. Dzielinski = SegeMa . 2J3, <br />Carvn'� NumperNP06 2713 <br />"„e�iH to vam county <br />My Commission Expires: September 8, 2031 <br />County of Residence: LaPorte <br />