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NON-COLLUSION AFFIDAVIT
<br />STATE OF OHIO )
<br />SS
<br />C U ~A~OG COUNTY )
<br />Bid identification
<br />Contractor,
<br />.~
<br />being first duly sworn, deposes and says that he is PiP~S/,n ~N
<br />(sole owner, a partner, president, secretary,
<br />etc.) of Old ~S TG~ C./~ ~.4/Yf TAI G 1J lid v~~ t ?~f' ~ c>I Gk. ~',t),¢C K S
<br />the party making the foregoing bid; that such bid is not
<br />made in the interest of or on behalf of any undisclosed person, partnership, company, association,
<br />organization, or corporation; that such bid is genuine 'and not collusive or sham; that said bidder has not
<br />directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not
<br />directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a
<br />sham bid, or that anyone shall refrain from bidding; that said bidder has not in any manner, directly or
<br />indirectly, sought by agreement, communication or conference with anyone to fix the bid price of said
<br />bidder or of any other bidder, or to fix any overhead, profit, or cost element, of such bid price, or, of that
<br />of any other bidder, or to secure any advantage against the public body awarding the contract or anyone
<br />interested in the proposed contract; that all statements contained in such bid are true; and, further that said
<br />bidder has not, directly or indirectly, submitted his bid price or any breakdown thereof, or the contents
<br />thereof, or divulged information or data relative thereto, or paid and will not pay any fee in connection
<br />therewith, to any corporation, partnership, company, association, organization, bid depository, or to any
<br />member or agent thereof, or to any other individual except to such person or persons as have a partnership
<br />or other financial interest with said bidder in his general business.
<br />SIGNED .~
<br />TITLE ~i
<br />Subscribed and sworn to me before this ;? ? day of ~ ~ ~-~ , 20 ~/
<br />(SEAL)
<br />.` .p
<br />_o~~\1 ~i%'~1~: BONNIE L. KNALL
<br />#i i* Notary Public, State of Ohio
<br />~' mission Expires Sept. 27, 2015
<br />9 ~ QP o,,., Recortad in Cuyihope County
<br />,,,~
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<br />'~ Notary Public
<br />NA-1
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