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STATE ENCUMBRANCE VERIFICATION <br />Individual certifies that funds have been encumbered as <br />required by Minn. Stat. §,>' 16A.15 and 16C.05. <br />Signed: <br />Date: <br />CFMS Contract No. A- <br />GOVERNMENTAL UNIT (The City of Shoreview) <br />Governmental Unit certifies that the appropriate person(s) <br />have executed the contract on behalf of the Governmental Unit <br />as required by applicable articles, bylaws, resolutions, or <br />ordinances. <br />By: <br />Title: <br />Date: <br />By: <br />Title: <br />Date: <br />Governmental Unit's Signature Acknowledgment <br />This instrument was acknowledged before me this _ day of <br />the <br />the <br />Mn/DOT Agreement No. 81650 <br />STATE AGENCY <br />By: <br />(with delegated authority) <br />Title: <br />Date: <br />COMMISSIONER OF ADMINISTRATION <br />As delegated to Materials Management Division <br />By: <br />Date: <br />ATTORNEY GENERAL <br />As to form and execution <br />By: <br />Date: <br />(title) <br />(title) <br />NOTARY PUBLIC: <br />and <br />and <br />200 by <br />(name) <br />(name) <br />(Governmental Unit) <br />[Notary Seal] <br />My Commission Expires: <br />♦ INLCUDE COPY OF RESOLUTION APPROVING THE AGREEMENT AND AUTHORIZING ITS EXECUTION. <br />Rev 11 /00 Joint Powe <br />Page 57 <br />al Services <br />6 <br />