HomeMy WebLinkAboutNON-COLLUSION AFFIDAVITS_Rev_0.)
., the Bidder that has submitted the attached Bid;
., 201 _.
Five Sullivan Brothers CC Kitchen Plmb Improvements 00 41 00
City of Waterloo NON-COLLUSION AFFIDAVITS
INVISION #16021 1 of 2
NON-COLLUSION AFFIDAVIT OF PRIME BIDDER
State of )
)ss
County of )
, being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Officer, Representative, or Agent) , of
, the Bidder that has submitted the attached Bid;
2. He is fully informed respecting the preparation and contents of the attached Bid and of all pertinent
circumstances respecting such Bid;
3. Such Bid is genuine and is not a collusive or sham Bid;
4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees, or
parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or
indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the
Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such
Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or
conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other
Bidder, or, to fix any overhead, profit or cost element of the bid price or the bid price of any other Bidder, or
to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against the
City of Waterloo, Iowa, or any person interested in the Proposed Contract; and
5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion,
conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents,
representatives, owners, employees, or parties in interest, including this affiant.
(Signed)
Title
Subscribed and sworn to before me this day of , 201 .
Title
My commission expires .
.)
He is fully informed respecting the preparation and contents of the subcontractor's proposal submitted by
., contract pertaining to the
Five Sullivan Brothers CC Kitchen Plmb Improvements 00 41 00
City of Waterloo NON-COLLUSION AFFIDAVITS
INVISION #16021 2 of 2
NON-COLLUSION AFFIDAVIT OF SUBCONTRACTOR
State of )
) ss:
County of )
, being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Officer, Representative, or Agent) , of
hereinafter referred to as the
"Subcontractor;"
2. He is fully informed respecting the preparation and contents of the subcontractor's proposal submitted by
the subcontractor to , contract pertaining to the
project in ;
(City or County and State)
3. Such subcontractor's proposal is genuine and is not a collusive or sham proposal;
4. Neither the subcontractor nor any of its officers, partners, owners, agents, representatives, employees, or
parties in interest, including this affiant, has in any way colluded, conspired, connived, or agreed, directly or
indirectly, with any other bidder, firm or person to submit a collusive or sham proposal in connection with such
contract or to refrain from submitting a proposal in connection with such contract, or has in any manner, directly or
indirectly, sought by unlawful agreement or connivance with any other bidder, firm or person to fix the price or prices
in said subcontractor's proposal, or to fix any overhead, profit or cost element of the price of prices in said
subcontractor's proposal, or to secure through collusion, conspiracy, connivance or unlawful agreement any
advantage against the City of Waterloo, Iowa, or any person interested in the proposed contract; and
5. The price or prices quoted in the subcontractor's proposal are fair and proper and are not tainted by any
collusion, conspiracy, connivance or unlawful agreement on the part of the bidder or any of its agents,
representatives, owners, employees, or parties in interest, including this affiant.
(Signed)
Title
Subscribed and sworn to before me this day of , 201 .
Title
My commission expires .