AFFIDAVIT BY CONTRACTOR CERTIFYING THAT THERE WAS NO COLLUSION IN BIDDING FOR CONTRACT
STATE OF ARIZONA )
) ss
CITY OF: )
____________________________________________________________________
(Name of Company, Representative)
being first duly sworn, deposes and says:
That he or she is___________________________________ of
(Title)
__________________________________
(Name of Company)
And that pursuant to § 112(C) of Title 23 U.S.C., he or she certifies as follows: That neither he nor she nor anyone associated with the said
__________________________________
(Name of Company)
has, directly or indirectly entered into any agreement, participated in any collusion or otherwise taken any action in restraint of free competitive bidding for the bid for the: ________________________
By:_______________________________________________________________________________
(Name of Individual/Representative)
Subscribed and sworn to before me this_________day of_____, 20____
Title:__________________________________
My Commission expires:___________________________________
(Notary Public)
(Res. 2008-011, passed 2-19-2008)