164-22 Exhibits to Agreement for Workers Compensation Third Party Administration - 2022.pdf

AFFIDAVIT OF NON-COLLUSION The undersigned bidder of full age, being duly sworn according to law depose and hereby specifically certifies that: A. To the best of the bidder's knowledge and belief, the annexed bid proposal for this project has not been prepared in collusion with any other bidder of ike item or services and the prices, discounts, terms and conditions thereof have not been directly or indirectly communicated by or on behalf of the bidder to any person other than the recipient of the bid and will not be communicated to any person prior to the official opening of the bid. B. The bidder fully understands that no premiums, rebates, or gratuities are permitted either with, prior to, or after signing of contract. Any violation will result in cancellation and removal from the bid list. C. The bidder further certifies that the undersigned has the necessary authority, to sign this stipulation stating that the bidder has not entered into any agreement, or otherwise taken any action in restraint of free competitive bidding in connection with this bid. All references to the bidder are understood to include ersigned and all principals, partners and officers of the bidder.. Date: David Harris, President (Name and Title) Claims Resolution Corporation, Inc. (Company Name) 323 S. Pitney Road, Suite 200 Galloway NJ 08205 (Address) (Corporate Seal) Subscribed and sworn to before me this [2 aay of Hay 2022. LAUREN F WALTER Notary Public - State of New Jersey Notary Seal My Commission Expires Aug 30, 2023