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Minn. Stat. 160.285, Subd,4.VERIFICATION OF COMPUANCE <br /> A contractor responding to a solicitation document of a contracting authority shall submit to the contracting <br /> authority a signed statement under oath by and owner of officer verifying compliance with each of the minimum <br /> criteria in subdivision 3,with the exception of clause(7),at the time that it responds to the solicitation documents. <br /> A contracting authority may accept a signed statement under oath as sufficient to demonstrate that a contractor <br /> is a responsible contractor and shall not be held liable for awarding a contract in reasonable reliance on that <br /> statement.A prime contractor,subcontractor,or motor carrier that fails to verify compliance with any one of the <br /> required minimum criteria or makes a false statement under oath in a verification of compliance shall be ineligible <br /> to be awarded a construction contract on the project for which the verification was submitted. <br /> A false statement under oath verifying compliance with any of the minimum criteria may result in termination of a <br /> construction contract that has already been awarded to a prime contractor or subcontractor that submits a false <br /> statement.A contracting authority shall not be liable for declining to award a contract or terminating a contract <br /> based on a reasonable determination that the contractor failed to verify compliance with the minimum criteria or <br /> falsely stated that it meets the minimum criteria.A verification of compliance need not be notarized.An electronic <br /> verification of compliance made and submitted as part of an electronic bid shall be an acceptable verification of <br /> compliance under this section provided that it contains an electronic signature as defined in section 3251.02, <br /> paragraph(h). <br /> Minn.Stat. 160.285,Subd.6.ADDITIONAL CRITERIA <br /> Nothing in this section shall restrict the discretion of a contracting authority to establish additional factors for <br /> defining contractor responsibility.This subdivision is not an independent grant of authority to a contracting <br /> authority to establish additional minimum criteria pursuant to subdivision 3. <br /> CERTIFICATION <br /> By signing this document,I certify that I am authorized to sign on behalf of the company,and I swear under oath <br /> that: <br /> 1) My company meets each of the minimum criteria to be a responsible contractor as defined in <br /> Minn.Stat. 16C.285, <br /> 2) I have included a list of my first-tier subcontractors with my company's solicitation response, <br /> 3) if my company is awarded - co =ct, will submit a list of additional subcontractors as required. <br /> Name of Company: " ,, ) . <br /> Authorized Signature: 41.---1 <br /> 0 <br /> Printed Name: -----Y- 49.4 \ -z— <br /> ., <br /> Title: i)..2- -, 8"1.1E--,,A-c-rte s <br /> Date: 1`Ict 2...17..w..ā€ž.., T- phone number: 7t 5-4 Z't- e.)—M <br /> Before me on this E 'N#''.-day of e ,20 t Ls ,personally appeared <br /> AC,li r4 I.. ,'r.i E Ca Ni -+ - known to be,who being duly sworn did depose and say that he is the <br /> PV EC xi I\F-{<1-1 (office)of the Contractor above mentioned that he executed the above <br /> Verification of Compliance and Affidavit on behalf of said Contractor;and that all of the statements contained <br /> therein are true,correct and complete. <br /> Attest: <br /> Notary Signature: ' -C 4'i Q 4; " <br /> Printed Name: e-1 t `$ C_-Pr E-; - trv4 C--r ry x- . <br /> My Commission expires: 'S. --,01/4. 72D t ,20 i <br /> Date: 1- i -. - I,L. Telephone number. lid-i -y 1-11`i t` <br /> ` JESSICA EUZAIETH <br /> L14 "" Notify Public <br /> x Minnesota <br /> salon E ! 31 7 <br /> --, <br /> VeriricaUon of CoViance <br /> ELKMU 134310 00 45 45-3 ,' <br /> 97 <br />