5.4. SR 01-07-2008 - Laserfiche WebLink

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Note: Bids to be open at 10:00am on December 17, 2007. Bid to be awarded or rejected at the City Council meeting dated January 7, 2008. City of Elk River 13065 Orono Parkway Elk River, MN 55330 Affidavit and information required of bidders Affidavit of non collusion I hereby swear (or affirm) under the penalty of perjury: 1) That I am the bidder (if the bidder is an individual) a partner in the bidder (if the bidder is a partnership), or an officer or employee of the bidder corporation having authority to sign on behalf (if the bidder is a corporation); 2) That the attached bid or bids have been arrived at the bidder independently, and have been submitted without collusion with, and without any agreement, understanding, or planned common course of action with, any other vendor of materials, supplies, equipment or services described in the invitation to bid, designed to limit independent bidding or competition; 3) That the contents of the bid or bids have not been communicated by the bidder or its employees or agents to any person not an employee or agent of the bidder or its surely on any bond furnished with the bid or bids, and will not be communicated to any such person prior to the official opening of the bid or bids; and 4) That I have fully informed myself regarding the accuracy of the statements made in this affida~ ~ Signed: ~ < Firm Name: Frank J. oni & Co., Inc. Subscribed and sworn to before me this 12 day of December 2007 Notary Public My commission expires ~ ~ ~ ,Year ,r,~ ~ d Bidder's E.L Number (Number used on Employer's Quarterly Federal Tax Return, U.S. Treasury Department Form 941): 95-2982566 Fair Trade Items; List below each item upon which bid is made, the price of which is affected by a resale price maintenance or "fair trade" contract between the bidder and the person or firm supplying the item to the bidder. (Use reverse side if necessary). WIK~IGEI ,--. ., ~a~ Ary comm. Ep,Yti ~r ~~. 2a~ E