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<br />06/07/99 12:12 <br /> <br />"a4417425 <br /> <br />CITY/ELK RIVER <br /> <br />f4l 007 <br /> <br />- -.- -- .-. <br /> <br />. <br /> <br />City of Elk River <br />13065 Orono Parkway <br />P.O, Box 490 <br />Elk River, MN 55330 <br /> <br />Affidavit and iIlfonnation required of bidders <br /> <br />Affidavit of non collusion <br /> <br />. <br /> <br />I hereby swear (or affinn) under the penalty of perjury: <br /> <br />1) That T am the bidder (ifthc bidder is an individual) a partner in the bidder (if the <br />bidder is a partnership), or an officer or employee of the bidder corporation <br />having authority to sign on behalf (if the bidder is a corporation); <br />2) That the attached bid or bids have been arrived at the bidder independently, and <br />have been submitted withuut colltlsion with, and \Vithout any agreement, <br />understanding, or planned common course of action with, any other vendor of <br />materials, supplies, equipment or set"vices described in the invitation to bid, <br />designed to limit independent bidding or competition; <br />3) That the contents of the bid or bids have not been c.:on11nunicated by the bidder or <br />its employees or agents to any perSOll not an employee or agent of the bidder or its <br />surely on any bond furnished with the bid or bids, and will not be communicated <br />to any such perSOll prior to the official opening of the bid or bids; and <br />4) That I have :fully informed myself regarding the accuracy of the statements made <br />in this affi "t. <br /> <br /> <br />~k-J- <br /> <br />Signed: / <br /> <br />, Year ~/ <br /> <br />~ <l ~'Ji <br /><&'d2 c~ <br />'':c-o:=::>~)' <br />~~oo,,; <br />n..~UUD! <br />.~::t:lln~~: <br />. . ::J C () ill ;., ~ <br />Q9 l" <( r3 ~, a; o{'..!) <br />19. '. "'0 'v. .p 0: It! ~\.,. <br />. ~ __J C. t) <br />r l3 Of ;. -< t; !( <br />'.'.;: [= b 0 ~\t) <br /><:C::8()-'u~' <br />I>: z >- <br />~ - ~ <br />---{ ~"""'N'--I <br />\ ~,:i0:~;~>\ V <br />~. ,;,:...:-:':....1 ::,;:1..... . <br />i':i.. ~ ; t; j t <br />; '\~_~~ ~~0/ i <br /> <br />~i\'l,;h~ <br /> <br /> <br />Firm Name; Frank J. <br /> <br />OCo., Inc. <br /> <br />ubscribed and sworn to bef9~e me this 10 <br />. V~ ~~ <br />Notary Public; <br />My commission expires ~ . ;lS~ <br /> <br />day of June <br /> <br />Bidder's RI. Number <br />(Number used on Employer's Quarterly Federal Tax RetllIll, U.S. Treasury <br />Department Form 941): 95-2982566 <br /> <br />Fair Trade Items; <br /> <br />List below each item upon which bid is made, the price ofwhich is affected by a <br />resale price maintenance OT '"fair trade" contract between the bidder and the person or <br />firm supplying the item to the bidder. (Use reverse side if necessary). <br /> <br />. <br />