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SECTION 00472 - NONCOLLUSION AFFIDAVIT OF PRIME BIDDER <br />lState of �% G <br />County of <br />1. <br />, being first duly sworn, disposes and says that: <br />(Name/s) <br />They are -p ( e-VIU��0'' of 1 <br />(Name of Company) <br />has submitted the attached bid; <br />the Bidder that <br />(Title) <br />preparation <br />the aration and contents of the attached bid and of all pertinent circumstances <br />2 He is fully informed respecting <br />INrespecting such Bid; <br />3 Such Bid is genuine and is not a collusive or sham Bid; <br />Neither the said Bidder nor any of its officers, partners, °onspired, connivedwners, agents, feoragreied directly or indirectly with <br />s or parties in <br />waycolluded, interest, including ir, firmhis affiant, has in anyin <br />anyother bidder, or person to submit a collusive or shorn onBe tion with stu�h Contract orn with the has inntract or anymannern, <br />ch the <br />attached bid has been submitted or to refrain from 9 <br />directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, I <br />orP erson to fix the price or prices in the attached Bid or of any other Bidder, or to <br />secure <br />throusongma any <br />l inion, <br />the <br />conspiracy, connivance or unlawful agreement any advantage against the Countyor an <br />proposed Contract and <br />The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, <br />part of the Bidder or any of its agents, representatives, owners, <br />conn <br />employees, <br />es or unlawful <br />in interest, incl ding thiaffiant. /. <br />employees, or p <br />(Signed) (� <br />(Title) t" <br />STATE OF FLORIDA } <br />COUNTY OF INDIAN RIVER}SS <br />The foregoing instrument was acknowledged before me this 1 1 1_ <br />(Date) <br />who is personal) known to me or who has produced <br />as identification and who did (did not) take an oath. <br />fr- <br />v\ <br />Nota (` . & sign -name) <br />Commission No. <br />DEPOi..- <br />MYO:.hnr.;s:- 3:::;3u39. <br />EXPIRES: Odcxr U3, MI5 <br />00472 <br />F:\Public Works\ENGINEERING DIVISION OF PRIME B DROJECTS\0845B - ld Dixie Hwy IA <br />Sidewalk (38th Ln - 45th St)\Admim\bid documents\P <br />Documents\00472 - NONCOLLUSIONAFFIDAVIT <br />