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I affirm that I am the Consultant, a partner of the Consultant firm, or an officer or <br />employee of the Consulting corporation with authority to sign on the Consultant's <br />behalf. <br />I also affirm that the attached has been compiled independently and without <br />collusion or agreement, or understanding with any other vendor designed to limit <br />competition. <br />Print Name <br />T,a10 <br />City / State / Zip Code <br />Telephone and Fax Numbers <br />Email. Address <br />Page 17 of 17 <br />