*Receive prior approval from supervisory personnel before performing this function. Reset generator and leave set in the remote position APPENDIX C: ACKNOWLEDGEMENT FORMS SIGNATORY DECLARATION I, the undersigned, acknowledge completion and receipt of the Authorized Signatory Declaration Form, and fully understand my responsibility as an Authorized Signatory on this document and all subsequent forms thereof requiring signature. In particular I understand rules regarding the referencing, checking, and verification as necessary for disclosure to award this bid or proposal as requested and defined within this document. The bid document as submitted has not been altered knowing all information must be filled out correctly for consideration. It is hereby understood that the Town of Salem reserves the right to reject any and all proposals or parts of proposals; to waive any defects, information, and minor irregularities; to accept exceptions to these specifications; to award contracts, or to cancel this request, if it is in the Town’s best interest to do so. Written Name of Authorized Signatory: _________________________________________ Title: _____________________________________________________________________ Signature: _________________________________________________________________ Date: _____________________________________________________________________ Company: _________________________________________________________________ Address: __________________________________________________________________ __________________________________________________________________ Phone: ____________________________________________________________________ Email: ____________________________________________________________________ NON-COLLUSION STATEMENT By Submission of the Bid or Proposal, the Bidder Certifies that: 1. This bid or proposal has been independently arrived at without collusion with any other