~~It V~e' - . 0, , - Jersey City

NON COLLUSION AFFIDAVIT
STATE OF NEW JERSEY
CIT OF JERSEY CITY ss:
I certify that I am (' .0 .0 .
of the firm of b "'Mvtr .. t G\e.COMM.\)(\\Cc;+iOf\S, LLC
the bidder mang the proposal for the above named project, and that I executed the said
proposal with full authority so to do; that said bidder has not, directly or indirectly entered into
any agreement, paricipated in any collusion, or otherwise taen any action in restraint of free,
competitive bidding in connection with the above named project; and that all statements
contained in said proposal and in this afdavit are true and corrct, and made with full
knowledge that the City of Jersey City relies upon the truth ofthe statements contained in said
proposal and in the statements contained in this affdavit in awarding the contract for the said
: project.
I further warrant that no person or sellng agency has been employed to solicit or secure such
contract upon an agreement or understanding for a commssion, percentage, brokerage or
contingent fee, except bona fide employees or bona fid tablished commercial or selling
agencies maintained by (N.J.S.A.52: - 5)
(Signature of respondent)
~(u N
SUBSCRIED AND SWORN TO
BEFORE ME THIS DAY 0~\J"" 1 l \ l\ OF 20Jö
(TYE OR PRIT NAME OF AFFIAT UNDER ~TITRE) _--
NOTARY PUBLIC OF ,M'S~Lv.c.\ ~ ;r
; MY COMMISSION EXPIRS: 20 \ \ ~ -""Q '~ L. Y '1 F reA C "
(NOTE: TIDS FORM MUST BE COMPLETED, NO
WITH TilS PROPOSAL).
DTJQ)~
Notarv Public
COMMONWEALTH OF MASSACHUSEns
My Coiiunilllon i.,i,.. Dtc.mii., lS, 20 II