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<br />NON-COLLUSION AFFIDAVIT <br /> <br /> <br />C.S.: 2713 (12=10) 903 Parcel: 16 <br /> <br />Sale Number 139477 <br />Conveyance 2010-0082 <br /> <br /> <br />STATE OF MINNESOTA ) <br /> ) ss. <br />COUNTY OF ) <br /> <br /> I, _________________________________________________________, being <br /> (Name of person signing this affidavit) <br /> <br />first duly sworn, do depose and say: <br /> <br />(1) that I am the authorized representative of _____________________________ <br /> <br />_______________________________________________________________ <br /> (Name of individual, partnership or corporation submitting this proposal) <br /> <br />and that I have the authority to make this affidavit for and on behalf of said purchaser; <br /> <br />(2) that, in connection with this transaction, the said purchaser has not either directly or indirectly entered into <br />any agreement, participated in any collusion or otherwise taken any action in restraint of free competitive <br />purchase; <br /> <br />(3) that, to the best of my knowledge and belief, the contents of this package have not been communicated by the <br />purchaser or by any of his employees or agents to any person who is not an employee or agent of the <br />purchaser, and will not be communicated to any person who is not an employee or agent of the purchaser, and <br /> <br />(4) that, I have fully informed myself regarding the accuracy of the statements made in this affidavit. <br /> <br />(5) Are you a current or former State of Minnesota Government Employee Yes No <br />If yes, please add department name and dates of employment. <br />_______________________________________________________________________________________ <br /> <br />______________________________________________________________________________________ <br /> <br /> <br />Signed: ________________________________ <br /> (Purchaser or authorized representative) <br /> Subscribed and sworn to before me <br /> <br /> This______________day of ________________, 20___ <br /> <br /> ________________________________________ <br /> Notary Public <br /> <br /> My commission expires___________________, 20___ <br /> <br /> <br />