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CITY OF ROSEVILLE <br /> 2660 Civic Center Drive <br /> Roseville, Minnesota 55113 <br /> Affidavit of Non-Collusion: <br /> I hereby swear or affirm)under the penalty of pe&ry: <br /> I. That I am the bidder(if the bidder is an individual),a partner in the bidder(if the bidder is a <br /> partnership),or an officer or employee of the bidding corporation having authority to sign on <br /> its behalf(if the bidder is a corporation); <br /> 2. That the attached bid or bids have been arrived at by the bidder independently,and have been <br /> submitted without collusion with and without any agreement, understanding, or planned <br /> common course of action with any other vendor of materials,supplies,equipment or services <br /> described in the invitation to bid, designed to limit independent bidding or competition; <br /> 3. That the contents of the bid or bids have not been communicated by the bidder or its <br /> employees or agents to any person not an employee or agent of the bidder or its surety on any <br /> bond furnished with the bid or bids,and will not be communicated to any such person prior <br /> to the official opening of the bid or bids; and <br /> 4. That I have fully informed myself regarding the accurac of th statements made in this <br /> affidavit. <br /> Z= <br /> Sig4a re <br /> Firm Name <br /> scribed and sworn <br /> to before me this day of MDV Ooo�J W- , 20 <br /> Notary Pub46 <br /> My com m is ion expires <br /> 122� <br /> NOTARY SEA <br /> 2 <br /> AMY LYNN LANGOWSKI <br /> Notary Public <br /> State of M <br /> My Commission Expires <br /> Januory 31 9 2015 <br /> innesota <br />