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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 /> 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 , 20 <br /> Notary Public <br /> My Commission Expires: <br /> Page 9 of 10 <br />