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1999-02-18_PERMIT FILE - M1999011
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1999-02-18_PERMIT FILE - M1999011
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Last modified
3/26/2024 3:45:40 PM
Creation date
11/24/2007 9:43:19 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1999011
IBM Index Class Name
Permit File
Doc Date
2/18/1999
Doc Name
CONSTRUCTION MATERIALS SPECIAL 111 OPERATION RECLAMATION PERMIT APPLICATION FORM
Media Type
D
Archive
No
Tags
DRMS Re-OCR
Description:
Signifies Re-OCR Process Performed
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COLORA00 DEPARTMENT OF TRANSPORTATION `H°fQr° <br />IN-0~ 4-185 <br />ANTI-COLLUSION AFFIDAVIT rec.: o.r <br /> Elba t tarty <br />I hereby avast Ihet I em Iha perooa raeparmbk WAlln my arm Eor We goal dacklon a^ to the prka(s) and aelounl of this <br />hN or, Y not. Ihat I havo wdaan aualodratlon, arrclo:ad herewith, Item tltal person to rrraaa the elelemenls cal out talo,v on <br />hk or ha; bebaA and on behaA cl my Ann. <br />I Nrdler aAas::het: <br />1. The Frce(sl end amount o' !h6 Wd have Dean arrived ea indapantlenay, withc ul censu Mallon, communlcallan or <br />agreamsnl Ier the ourpcse or with!ho offecl of resl•kling xmpoNtbn with an/ ether fym Q peroor, n'hc b 9 bldtler <br />s ar pcmmkl prima 6Hdrr. <br />2A. Nether lhs pnco (s) riot Ate amoun: of Ihla Dld have been diselosey to soy oUler Arm or person who la a bidder e' <br />' pctenllal p~yne 6tdtlar cn 1h15 proJecl, and vAl rim he so rLscloaed prior b bid operirrg. <br />26. Neahsr Ihs prkns nw Ills emcunl o11t,E bid of eny Diller lirtn a psrson who Is a tidder o• pole TrlN artrle bldyer on <br />Ihi6 pre(9:1 have been d"odosed to RIO or my I.rn. <br />3A. No ells mpl Fes been made to scltll, cause a Iodise any amn or (serson who Is a bidder apo lenlial prima blooer 4 <br />re'raln Iran bMting cn tnr pro(e.:4 or Ic atAmin ^ bid hlglwr than the bltl of Itb flrn, ar any Irdenl:ona~y Ngh or non- <br />oompe'Aivabid arolder Icmn o1 mmylementary hid. <br />3b. No eg memstl has neon plomisodaaclloXed for arty other llrm or parson vno lsahWderaposerlist pdrtle 6dder <br />on this prolaa b suornM an 1'lenllonalty hlgr, noncompegtWa ar other form al ooRpbmentery bid on In6 pra(eq. <br />4. The lid cl my flan Is mays in good felAl and n>; punuanl l0 any cofLSUhal~on, comnJr Mallon, egl4arnenl or <br />dlswaamn wmh, cr hd•ternen: or aclieAat;or, by or rrcm eny Ilan m person to autmA any Intem analy high, non:om• <br />pelos.e or char roan cl corrplenranW ry bid. <br />5. My lum Ilrc nc; oflerad or a flared Inb a aubcon:recl or agroem:ent rc~ardng the pJ.ehase ar eels al mlaeerals or <br />aervces Iran erq~ II ~m or oa 1:on. or ctlerad, promised ar paid rasn ar any:hilg al wius to anyfYm a person. <br />whether In <onnecnlon vrli 1%ia a any olhe• prajeG. in oonaA7arallon for an agreement or promise by Ery IYm or <br />person b relra6n Irom tiddinA a to a ubmll any IKsn:lonally hlph, nanoe mpsW vs or otna form or mmplemenlery 6.d <br />or EgreEing ar promising b do co an tkk pro(r_t. <br />E. My flan hoe n~: acoorrtad or been pramked eny suboeniraU or egraamenl ragardlrg the sale el rr®le rlala or <br />servcos to any firm cr poracn, one hea ncl bean prcmked ar paid uch or anyth.ing of va~~c by any I.rm or peraor, <br />wiralher It connedlon wMlr this or ery o:har oroJed, In coneldaretlon for my l;mnk submhanp NY intenllonafly high, <br />ronmmpalllve or ether loon cl corrrlamenLry bid, cr agreeing or promising to do sb, en Ihi9 pro(ae:_ <br />?. I hsva made a dYi6ent Yaaulry d ell members, officers, anplayeas, end ageraa d Ilan wan resporafDtllas ralatlrip <br />to Iha preparation <br />epprwel or aubmisstn of my firm's hYJ an Ills <br />robed end hate been ad <br />i <br />d b <br />' <br />K <br />, <br />p <br />+ <br />se <br />y <br />eO <br />r of them <br />that he ar cho her rqt paMcpaled In any W mrrlunka110r1, contwAatba, dkcusslo.t, agre9rllenl, catusbn, or Other <br />arrdct IncotssteN with ~'y o' Ihs statements end represenlatlo.na Redo In This alfylevit. <br />B. I urcelsland end my IIRn underslarlds Inel ery miyata:emanl M IHs afiida~M Is end shall 6e puled as a laudulenl <br />cmcealment from Iha Colorado Department of Transpo!~tlon, of the truE lags re(3Na~J tc submission d bAya la thla <br />cau+aa. <br />1 D~tARE UfIDER PEhAL'Y OF PERJURY IN rHE SECOND DF13fyEE, M~D ANY OTHER APPLICP,BLE STATE OR <br />FEDERAL LAVJ$ THAI i~E STATEMENTS -Mf]E ON THS DOCUAIBdT APE TRUE AND GCaf PIETE TO 7HE QEST <br />OF CRV KNOWLEDGE. <br />tarry. 6,,.. sown ,un. <br />oar <br />` ~'2"~ <br />Azle hhtsrial5 8 Construction Calgary <br />,~ <br />presidelrt <br />ire eraraarlm.nrvTan, nrn.. Qr pN NNVrI er O.t. <br />I <br />1'M i <br />Syr m l0 6e'ore me this 2nd day bf, ``~~t1 ~• /!/~~ <br /> <br />rare raa ~ <br /> <br />a, Jme ~7~01 PUSItG c C <br /> <br /> <br />t9 <br />70 <br />N <br />GI <br />OI <br />W <br />m <br />m <br />3 <br />D <br />m <br />.Z] <br />D <br />tD <br />m <br />A <br />
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