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NONCOLLUSION AFFIDAVIT OF PRIME BIDDER <br />State of - f (b VU � } <br />County of 1,V '. } <br />(Name/s) being first duly sworn, disposes and says that: <br />1. They are"I"1(i� L6i/ct of V1 V-VA0 u U) %Usc cuVj, ,f the Bidder that <br />(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, <br />or employees parties in <br />Y <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 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 />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 propel 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, owners, <br />employees, or parties in interest, including this affiant. <br />(Signed) <br />! (Title) <br />STATE OF FLORIDA } <br />COUNTY OF INDIAN RIVER)SS: <br />The foregoing instrument was acknowledged before me this <br />(Date) <br />by I t w1t7 C' who is personally known to me or who has produced <br />>� �{ as identification and who did idof Make an -oath. <br />ry qPPpLBr VICKIELEEIWRIGHT I; Nota rint sl n nam <br />z * <br />e <br />�V * o Notary Public h state of Florida (P 9 ) <br />Commission No. �D'7 S% <br />'V My C�ammitalon Exla, March 11, 2012. <br />Ummlulon II! DO 766883 E <br />... _ <br />id <br />a <br />00472 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1024-17thStreet and IR Blvd Intersection\Admim\Contract Documents\00472 - <br />NONCOLLUSION AFFIDAVIT OF PRIME BIDDER.doc <br />