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NONCOLLUSION AFFIDAVIT OF PRIME BIDDER <br /> State of <br /> County of }' ti ( .Vti ILWe'VL=l } <br /> �^ ( y t being first duly sworn , disposes and says that : <br /> ( Name/s ) <br /> elm <br /> -� <br /> 1 . They are ke, S1cQ-eVC1 of e I1y U-11-k rL4Se ( Ot the Bidder that (Title ) <br /> ( Name of Company) <br /> has submitted the attached bid ; <br /> 2 . He is fully informed respecting the preparation and contents of the attached bid and of all pertinent circumstances <br /> respecting such Bid ; <br /> 3 . Such Bid is genuine and is not a collusive or sham Bid ; <br /> 4 . Neither the said Bidder nor any of its officers , partners , owners , agents , representatives , employees or parties <br /> in <br /> interest, including this affiant , has in any way colluded , conspired , connived or agreed , directly or indirectly with <br /> any other bidder, firm or person to submit a collusive or sham Bid in connection with the contract for which <br /> the <br /> attached bid has been submitted or to refrain from bidding in connection with such Contract or has in any manner , <br /> directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm <br /> or person to fix the price or prices in the attached Bid or of any other Bidder, or to secure through any collusion <br />, <br /> conspiracy, connivance or unlawful agreement any advantage against the County or any person interested in the <br /> proposed Contract ; and <br /> 5 . The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion , conspiracy, <br /> connivance or unlawful agreement on the part of the Bidder or any of its agents , representatives , <br /> owners , <br /> employees , or parties in interest, including this affiant . <br /> (Signed ) <br /> � <br /> STATE OF FLORIDA } (Title ) <br /> COUNTY OF INDIAN RIVER}SS : <br /> The foregoing instrument was acknowledged before me this I I '7 (' <br /> �" (Date) <br /> by: 1 1 VVIV `� who is p rsonally known to me or who has produced <br /> 1� as iden 'fica io w o did d not) t ke an <br /> s <br /> ��— \r l � 2 L2 � 12� <br /> E <br /> PY pG <br /> 'F �n VICKIELEE WRIGHT i Notary ( print & ign name ) <br /> moon <br /> NofaryPubllc • State } FloridaCommission No,,� . �w �Y Camml6tlpn Exp, Mph 11, 2012 <br /> v ea Commuon # DD 7b6gq <br /> 00472 <br /> F :\Public Works\ENGINEERING DIVISION PROJECTS\0745- Indian River Blvd Sidewalk Imp . Proi 12th_17th St. (LAP )\Admim\bid documents\00472 - <br /> NONCOLLUSION AFFIDAVIT OF PRIME BIDDER .doc <br />