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R93-107 AUTHORIZING AGREEMENT FOR ADMINISTRATIVE SERVICES FOR SELF-INSURANCE PROGRAM
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R93-107 AUTHORIZING AGREEMENT FOR ADMINISTRATIVE SERVICES FOR SELF-INSURANCE PROGRAM
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Last modified
7/15/2016 11:48:46 AM
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7/15/2016 11:48:44 AM
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Resolution/Ordinance
Res Ord Num
R93-107
Res Ord Title
AUTHORIZING AGREEMENT FOR ADMINISTRATIVE SERVICES FOR SELF - INSURANCE PROGRAM FOR DECATUR PUBLIC TRANSIT SYSTEM
Approved Date
7/19/1993
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• EXHIBIT 6 <br /> , � .. .' NONCOLLUSI�N AFFIDAVIT ' <br /> w �I �" <br />�I . Scn•rE OF' 1`1�,V1� JQtS�� 1 . In�.�rrnrrr: ��,t:: .,c� i��..��c ��.� t�• p���•,r1�. <br /> � � �:cn{�lrttr! an1 s��mittn! �i[h all htds <br /> , �«� of� Ma�rr�s --- ' <br /> R,� � Ei�21� bci tirst duly swrn, deposes ar�d sap� tha[ he ts <br /> G. . � <br /> (E�ccr � o persai ing a ic�avtt) <br /> Se�t�o�' V�Ce �res�de�� � <br />' ( Cec c a+ner , A Partner . Presi n[ , o� o[ r pcvper ti[ e) <br />' of GRg P�us�ness SerJ�ces, =�C� • . the biddcr submitting this pivposal; <br /> tc� �amc o icm) <br /> tAat such bid �as no[ made in the intecest o[ or on behaif ot any urxfisclosaf perso�, partne�ship, <br /> ec:rpany, oc�aniutio�, or tvrpo�ation; that sud� bid is �enuine ard noc eollusive o� shar.,, and Nat <br /> saiJ bidricr h�s not bocn a p�rty to any agcco�cnt or eollusion arorr� biddcrs or prospective biddcrs <br /> in restraint of [rcY.dan ot co��ctitim by +►qr•mc.,+,cnt to b[A a fixeci prioc. or othec++ise, or to e^train <br /> [rom hidding arri ha� �oc, dic�ccly �r iMircctly, by a9c�em^nc, eamunicwti�n or eonterence �iN ' <br /> ar�w�e, atte+rpcai to induce accim pc'ju'licial to Ne interest of tl�e City of Decatur, <br /> � I1 i inot s oc �[ a�y hi�fcfer o� wnya�e �1.e intecastecl in t,M� pc�nseci c�c*+trwcc. <br /> �- <br />, 0�� <br /> SUl�HJ11F:!) /Wp 51i�W '[O NF:t011F: MF: tht•t I <br /> �5�g�ature o {�raun �n �uy a ti avtt) � <br /> �d a y n E _�����.19_� �I <br /> (SEI�L) ' ', <br /> tbtary P I <br /> R66 (12/81) � <br /> , I <br /> . ELIGIBLE BIDDER CERTIFlCATE <br /> :, G. Qv �� E► ler �«� cc�tity Nat <br /> (E7�ter o astpany o ►cia ing e eerti tcation) . <br /> Spn►or V►ce P�es�den� is � i�l��a� � <br /> (Q►ter nane o icm or ahidi ceRt cac on �s e) <br /> U.S. Cbrtptroller Gencral•s Cortsolidated List of Prrsons or Pirns Dcbarred F1ran Federal Contracts for <br /> violacions of various public contracts tncocperacing labor standecds isions. � <br />. . ..,.�-- . <br /> Sl�SCkIBF'.� AND Q+I�RN 7U HEF'Oltt: NE t�is <br /> 7 �iS qiatucc o cnq>any o tcta <br /> �C�_day ot _y���_.19��- <br /> P�:�tar,� F'ubl+�- <br /> € �fa:=�ar .�,_E����; �;t^,� <br /> �_�l.�y l,;'� _.l C:; ��,) 1iF'1�1.1 <br /> iSta ry � " � � <br /> -,�.-. ::� ._ �, .:..1 <br /> . NOTF:: 'It�is toc�n autt Ae s�itted �iN hids cnly foc eont�sct� to be tuncieA hy IRfTlVICDT <br /> � ' . . <br /> R67 (12/81) <br />
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