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2017-005B
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2017-005B
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Last modified
2/17/2017 11:18:39 AM
Creation date
2/17/2017 11:18:12 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
01/17/2017
Control Number
2017-005B
Agenda Item Number
8.E.
Entity Name
Timothy Rose Contracting
Subject
Contract and Specifications
43rd Ave, Sidewalk Improvements
Area
Aviation Blvd. to Airport Drive West
Project Number
1123
Bid Number
2017013
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SECTION 00472 <br /> NONCOLLUSION AFFIDAVIT OF PRIME BIDDER <br /> State of VALID } <br /> County of <br /> being first duly sworn, disposes and says that: <br /> (Name/so <br /> 7. They ar ., l.cc - of � � <br /> the Bidder that (Title) <br /> e of <br /> (NamCompany) <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 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 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 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, owners, <br /> employees, or parties in interest, including this affiant. <br /> (Signed) <br /> iv <br /> (Title) <br /> STATE OF FLORIDA } <br /> COUNTY OF INDIAN RIVER}SS: <br /> The foregoing instrument was acknowledged before me this <br /> y (Date) <br /> b : � � � � who is,�ersopallylcno�wn to me or who has produced <br /> as identification and who did(did not)take an oath." <br /> rrae�rat�� � Wt+�tk�0 <br /> >'Y F� <br /> ��. DEB® WEST otary(print& sign name) <br /> L MY COMMISSION#FF904578 Commission No.-CI <br /> o rXp1YES.October 03,2019 <br /> ��OF FLOP <br /> lR.fl+r�+ft�'iS'43t!`c.YfyfF3�.h5'�;, I, <br /> 00472-1 <br /> F•\Public Works\ENGINEERING DIVISION PROJECTS\1123 43rd Ave Sidewalk Improvements 26th St.to Airport Dr West\Admim\bid <br /> documents\Master Contract Documents\00472-NONCOLLUSION AFFIDAVIT OF PRIME BIDDER.doc <br />
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