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/.' <br />NON - COLLUSION AFFIDAVIT <br />State of North Carolina <br />County of Orange Proposal Request No. 5198 <br />being first duly sworn, deposes and says that: <br />I. He /She is the of the proposer that has <br />submitted the attached proposal; <br />2. He /She is fully informed respecting the preparation and contents of the attached proposal and of all <br />pertinent circumstances respecting such proposal; <br />3. Such proposal is genuine and is not a collusive or sham proposal; <br />4. Neither the said proposer nor any of its officers, partners, owners, agents, representatives, employees <br />or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, <br />directly or indirectly, with any other proposer firm or Person to submit a collusive or sham proposal in <br />connection with the contract for which the attached proposal has been submitted or to refrain from <br />proposing in connection with such contract, or has in any manner, directly or indirectly sought by <br />agreement or collusion of communication or conference with any other proposer, firm or person to fix <br />the price or prices in the attached proposal or of any other proposers, or to fix any overhead, profit or <br />cost element of the proposal price of the proposal of any other proposer or to secure through collusion, <br />conspiracy, connivance or unlawful agreement any advantage against the County of Orange or any <br />person interested in the proposed contract; and <br />5. The price or prices quoted in the attached proposal are fair and proper and are not tainted by any <br />collusion, conspiracy, connivance or unlawful agreement on the part of the proposer or any of its <br />agents, representatives, owners, employees, or parties in interest, including this affiant. <br />Signature <br />Title <br />Subscribed and Sworn to Before Me, <br />This day of J20 <br />Notary Public <br />My Commission Expires: <br />Page 9of10 <br />