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City <br />f LaPorte <br />E`t.kh"keJ78@2 <br />ChereH Daeurrier, Purchasing Manager <br />8.1 Bid Execution ByeCorporation <br />The undersigned, hereby acknowledges having received Solicitation Number.containing afull set ufContract <br />Documents, including but not limited to, 1) Requirements for Bidding and Instructions to Bidders, @) Standard Terms and <br />Conditions - General Conditions, 3) Special Conditions, 4) Contract Plans or Drawings (if applicable), 5)Detailed <br />6) Proposal Pages, 7)Certifications and 8)Addenda Nos. (none unless indicated here) <br />thxtthecorpurabnnshall bebound bya|/thetermsandconditions cnntain din e n the Contract and affirms <br />e rac�uocumentsreQard|essofwhether <br />a complete set thereof it attached to this proposal or bid, except only tothe extent that the corporation has taken express <br />written exception thereto in the sections of this solicitation designated for that purpose. Under penalty of perjury, the <br />undersigned: (1)warrants that he/she was authorized tosubmit this execution page on behalf ofthe Disclosing party, (2) <br />warrants that all certifications and statements contained in the execution pages are true, accurate and complete as of the date <br />the execution page was submitted; and (3) further warrants that, as of the date of submission of this solicitation there have <br />been no changes in circumstances since the date that the Execution page was submitted that would render any certification <br />in the execution page false, inaccurate or incomplete. Furthermore, the undersigned being duly sworn, deposes and says on <br />oath that no disclosures of ownership interests have been withheld and the information provided therein to the best ofits <br />knowledge is current and the undersigned has not entered into any agreement with any other Bidder (proposer) or prospective <br />Bidder (proposer) or with any other person, firm or corporation relating tothe price named in this proposal or any other <br />proposal, nor any agreement or arrangement under which any act or omission in restraint of freedom of competition among <br />Bidders (proposers) and has not disclosed to any person, firm or corporation the terms of this bid (proposal) or the price named <br />herein. <br />Proposals must be submitted with original signatures in the space provided. Proposals not properly signed will be rejected. <br />_~ <br />NAME OF CORPORATION- (Print or Type) <br />SIGNATURE OF PRESIDENT*: <br />(or Authorized Officer) (Signa�t.r) <br />TITLE OF SIGNATORY: <br />_�Print or Type) <br />BUSINESS ADDRESS: )k <br />(Print or Type) <br />*Nvte:mthe memmatthisbid (pmnmaVissigned uvotommanthe President, attach hereto acertified copy ofthatsection mCorporate By -Laws <br />mother authorization, such earesolution uvthe Board vfDirectors, which ermitsthto sign the offer for the Corporation. <br />(corporate seo6f'gi�/signatv'4) (Affix Corporate Seal) <br />State of County of <br />This |nstrumentwasacknowledged before mcnnthis � day <br />as rao(n, other authorized officer) and — <br />Name). <br />Commission Expires: <br />N ary Public Signature <br />~ `�� County of--. ' U <br />