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pf_03243
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pf_03243
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Last modified
7/17/2007 1:10:43 PM
Creation date
12/9/2004 6:58:20 AM
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<br />STATE OF MINNESOTA <br />COUNTY OF /'1-'" '1 t! f 0 fA <br /> <br />) <br />) SS <br />) <br /> <br />AFFIDA VIT OF NON-COLLUSION: <br /> <br />I hereby swear (or affirm) under the penalty of perjury: <br /> <br />I. That I am the bidder (if the bidder is an individual), a partner in the bidder (if the bidder <br />is a partnership), or an officer or employee of the bidding corporation having authority to <br />sign on its behalf (if the bidder is a corporation); <br /> <br />2. That the attached bid or bids have been arrived at by the bidder independently, and have <br />been submitted without collusion with, and without any agreement, understanding, or <br />planned common course of action with, any other vendor of materials, supplies, <br />equipment or .servjces described in the invitation to bid, designed to limit independent <br />bidding or competition; <br /> <br />3. That the contents of the bid or bids have not been communicated by the bidder or its <br />employees or agents to any person not an employee or agent of the bidder or its surety on <br />any bond furnished with the bid or bids, and will not be communicated to any such <br />person prior to the official opening of the bid or bids; and <br /> <br />4. That I have fully informed myself regarding the accuracy of the statements made in this <br />affidavit. <br /> <br />t!Au; <br /> <br />~~ <br /> <br />Signature <br /> <br />)( e (/1 1-+ <br />Firm Name <br /> <br />E J(C &i va ~., ^ '9 I"1c <br />- <br /> <br />Subscribed aud sworn to before me ~ <br /> <br />v( 7Ztf?t. ~ <br />Notary: <br />My Commission Expires: I' 3 ( - CJ 5' <br /> <br />NOTARY SEAL <br /> <br />.ANvt,A-V...~.~.a.t flff 4 <'!t~A.~M. <br />I ,.,.."" RICK L. HAal$CH , <br />. . ), NOTARY fOUBLIQ.MINNIiSOTA <br />WRIGMT COUNTY <br />MYCOMMISSION EXPIRES 1.:11-2005 <br />. . <br />
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