4.2. SR 07-23-2001 - Laserfiche WebLink

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City of Elk River 13065 Orono Parkway P.O. Box 490 Elk River, M2q 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 fulzl_~nformed myself regarding the accuracy of the statements made in this affidav Signed: Firm Name: EARL F. ANDERSEN, INC. Su~bscribed and sworn to before me thij. 20TH day of JULY 2001 N6.~-y Public My commission expires 1/31/ , Year 2005 Bidder's E.I. Number ~'~;'::":",.. JEANNETTE H. MARTZ ~ (Number used on Employer's Quarterly Federal Tax Return, U.S. Tr~~ SOT^~¥ ~u~C- u,ssi*O*^ ~ Department Form 941):41-1265810 }. ',.~ My Comm. [×!~,res dan. 3, 2005 ~ 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).