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DocuSign Envelope ID:41 B27956-1 C1 7-475E-9558-D6D38ABE1436 <br /> NON-COLLUSION AFFIDAVIT <br /> State of North Carolina <br /> County of Orange Proposal Request No. 5212 <br /> being first duly sworn, deposes and says that: <br /> I. He/She is the of , the proposer that <br /> has submitted the attached proposal; <br /> 2. He/She is fully informed respecting the preparation and contents of the attached proposal and <br /> of all 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, <br /> employees or parties in interest, including this affiant, has in any way colluded, conspired, <br /> connived or agreed, directly or indirectly, with any other proposer firm or Person to submit a <br /> collusive or sham proposal in connection with the contract for which the attached proposal has <br /> been submitted or to refrain from proposing in connection with such contract, or has in any <br /> manner, directly or indirectly sought by agreement or collusion of communication or <br /> conference with any other proposer, firm or person to fix the price or prices in the attached <br /> proposal or of any other proposers, or to fix any overhead, profit or cost element of the <br /> proposal price of the proposal of any other proposer or to secure through collusion, conspiracy, <br /> connivance or unlawful agreement any advantage against the County of Orange or any person <br /> 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 <br /> any collusion, conspiracy, connivance or unlawful agreement on the part of the proposer or <br /> any of its agents, representatives, owners, employees, or parties in interest, including this <br /> 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 /> STATE OF NORTH CAROLINA <br /> Page 11 of 12 <br />