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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 South c�:nd Imo_ this 23rd � � day of JUIY 2019 <br />Riet;E,a—RiN y-on,truglo—r Co ,Inc. <br />eof r aan4aKon) <br />fly ._W._ <br />Jos 65A. Icl , Sales Manager <br />uo of For , ning) <br />ACKNOWLEDGEMENT <br />STATE OF Indiana } <br />COUNTY OF St. Joseph ss <br />Before me, a Notary Public, personally appeared the above -named Joshua A. McCormick and <br />swore that the statements contained In the foregoing document are true and correct. <br />Subscribed and sworn to before me this 23rd day of l 9 <br />Dawn E. Arms rong <br />My Commission Expires: 4/18/23 <br />`hm wm�NN 4'J�d�onaelNMillww.���p Nu�V�'„kktawNlfgN4.mYl�'�kgmeN®O�CiW�wi dRN'MoouMJwu�IIN,� pI�NYO! Wtlf�9Meu�mmMami <br />County of Residence: LaPorte <br />Ii��o��nH� a u��7ul�lN�:��x a ���Iwaa�runn <br />� <br />L aPci t com^fly <br />I <br />665596 <br />� "" <br />poy a a71limiin i oun � xpfi�C, s <br />�t.Ou II1 81, 2023 <br />�uudiw�uua�art�mm�uwww�amunor�lo��mw"�1u��ror�;�pwnwu�nim'�asm°�rod�u�mo <br />