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<br />~ <br />~~~ILLS <br /> <br />. <br /> <br />April 13,2006 <br /> <br />Purchasing Department <br />Bluc Cross Blue Shield Minnesota <br />3535 Blue Cross Road <br />Eagan, MN 55122 <br /> <br />The undersigncd ccrtifics that to the best of his/her knowledge: (check onc) <br /> <br />Ii'! There is no officer or employee of Blue Cross Blue Shield Miunesota (Bluc Cross) who has, or <br />whose relative has, a snbstantial interest in any contract award subscquent to this proposal/bid. <br /> <br />o The names of any and all public officers or employees of Blue Cross who havc, or whosc relative has, <br />a substantial interest in any contract award subsequent to this proposalibid arc idcntified by name as <br />part of this submittal. <br /> <br />The undersigned further certifies that their firm (check one) u IS or Ii'! IS NOT currently debarred, <br />suspended, or proposed for debarment by any federal entity. The undersigned agrees to notify Bluc Cross <br />of any change in this status, should one occur, until such time as an award has been made under tbis <br />procurement action. <br /> <br />. <br /> <br />The undersigned also certifies that their firm (including any employee or contractor or firm) has not <br />offered or provided (and will not offcr to provide) any gifts, gratuities, or other considcrations to any Blue <br />Cross cmployee for purposes of inducing Bluc Cross to accept its proposal. <br /> <br />City of Arden Hills <br />1245 West Highway 96 <br />Arden Hills MN 55112 <br />Phone 651.634.5120 <br />Fax 651.634.5137 <br />4 1-6008992 <br /> <br />In compliance with Request for Proposals No. 499 for Active Community Planning, and after carefully <br />reviewing all the terms, conditions, and requirements contained therein, the undersigned agrees to furnish <br />such goods/services in accordance with the specifications/scope of work. <br />1"'-, <br />~cc/2t) '~ <br />-;: ,~' I 1-,_ <br />(j, .....:A______,::c'\ <br />l <br />Karen Barton, ~mmunity De~el~pfuent DirectOr <br /> <br />6----1' <br /> <br /> <br />. <br /> <br />City of Ardt'll Hills . 1245 Wcst HighW3Y 9(1 . Arden Hills, i\1~ . 55112~5i43 <br /> <br />\\;..1"'\1 u- iIU;:,.ll:> \<11 dt:1 II Ii II:, IJ'lhlllllillg ICW III r1Ulti1Yi'Jevelopment\uranIS\tR.l::S~ tlTanl1f49g Proposal LcrllllC<\\l..oiiTorm Letter-doc <br />Phone 651.634.5120 . Fax 651.634.5137 . wWw.ci.~lnlen.tH IS.HIII.IIS <br />