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NONCOLLUSION AFFIDAVIT OF PRIME BIDDER <br /> State of } <br /> County of } <br /> being first duly sworn , disposes and says that: <br /> (Name/s) <br /> 1 . They are of the Bidder that <br /> (Title) (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 <br /> circumstances 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 <br /> parties in interest, including this affiant, has in anyway colluded , conspired , connived or agreed , directly or <br /> indirectly with any other bidder, firm or person to submit a collusive or sham Bid in connection with the <br /> contract for which the attached bid has been submitted or to refrain from bidding in connection with such <br />.. Contract or has in any manner, directly or indirectly, sought by agreement or collusion or communication or <br /> conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other <br /> Bidder, or to secure through any collusion , conspiracy, connivance or unlawful agreement any advantage <br /> against the City/County or any person interested in the 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 , <br /> conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents, <br /> representatives, owners , employees, or parties in interest, including this affiant. <br /> (Signed ) <br /> (Title) <br /> STATE OF FLORIDA } <br /> COUNTY OF PALM BEACH }SS : <br /> r The foregoing instrument was acknowledged before me this <br /> (Date) <br /> by: who is personally known to me or who has produced <br /> as identification and who did (did not) take an oath . <br /> r <br /> Notary (print & sign name) <br /> Commission No . <br /> P-62 Noncollusion Affidavit <br /> 3rv2M6 9.54:29 AM <br />