Affidavit of Noncollusion State of Minnesota Request for Proposals Instructions: Please return your completed form as part of the Response submittal. I swear (or affirm) under the penalty of perjury: 1. That I am the Responder (if the Responder is an individual), a partner in the company (if the Responder is a partnership), or an officer or employee of the responding corporation having authority to sign on its behalf (if the Responder is a corporation). 2. That the attached proposal submitted in response to the Small Theatre Grants Request for Proposals has been arrived at by the Responder independently and has been submitted without collusion with and without any agreement, understanding or planned common course of action with, any other Responder of materials, supplies, equipment, or services described in the Request for Proposals, designed to limit fair and open competition. 3. That the contents of the proposal have not been communicated by the Responder or its employees or agents to any person not an employee or of the Responder and will not be communicated to any such persons prior to the official opening of the proposals. 4. That I am fully informed regarding the accuracy of the statements made in this affidavit. Authorized Signature Responder’s firm name: Print authorized representative name: Title: Authorized signature: Date (mm/dd/yyyy): Notary Public Subscribed and sworn to before me this: day of , Notary Public signature Commission expires (mm/dd/yyyy)
Affidavit of Noncollusion State of Minnesota Request for Proposals Instructions: Please return your completed form as part of the Response submittal. I swear (or affirm) under the penalty of perjury: 1. That I am the Responder (if the Responder is an individual), a partner in the company (if the Responder is a partnership), or an officer or employee of the responding corporation having authority to sign on its behalf (if the Responder is a corporation). 2. That the attached proposal submitted in response to the Small Theatre Grants Request for Proposals has been arrived at by the Responder independently and has been submitted without collusion with and without any agreement, understanding or planned common course of action with, any other Responder of materials, supplies, equipment, or services described in the Request for Proposals, designed to limit fair and open competition. 3. That the contents of the proposal have not been communicated by the Responder or its employees or agents to any person not an employee or of the Responder and will not be communicated to any such persons prior to the official opening of the proposals. 4. That I am fully informed regarding the accuracy of the statements made in this affidavit. Authorized Signature Responder’s firm name: Print authorized representative name: Title: Authorized signature: Date (mm/dd/yyyy): Notary Public Subscribed and sworn to before me this: day of , Notary Public signature Commission expires (mm/dd/yyyy)