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CER'1ikICATION BY SECRETARY AND TREASURER OF RELIEF ASSOCIATION <br />MUNICIPAL FIRE DEPARTMENT OR INDEPENDENT NONPRO} 11' FIREFIGHTING CORPORATION <br />We certify, that to the best of our knowledge and belief, the facts presented in this report are true and correct. <br />Signature of Secretary of Relief Association Business Phone <br />181/-392 9 <br />Signature of Treasury of Relief Association Business Phone <br />She of Municipal Clerk OR if <br />Independent Nonprofit Firefighting Corporation <br />The Municipal Clerk of largest municipality <br />in population contracting with <br />Independent Nonprofit Firefighting Corporation <br />,,_'...r,_ <br />Signa ure of Secretary of Inde. A dent Nonprofit <br />Firefighting Corporation (if applicable) <br />/V -av77 <br />Business Phone <br />Z -22 -93 <br />Date <br />< - -7r-% <br />Date <br />3- 9-3 <br />Date <br />1721/-2-7a3. a•as 93 <br />Business Phone Date <br />ATTESTATION BY INDEPENDENT PUBLIC ACCOUNTANT <br />Pursuant to Minn. Stat. § 69.051 subd. la(b), an independent public accountant <br />shall examine the financial information included within the financial section of <br />this reporting form. The independent public accountant shall attest to the <br />financial information required by Minn. Stat. § 69.051 subd. la(a). The <br />examination should be conducted in accordance with standards established by the <br />American Institute of Certified Public Accountants and should include such <br />procedures as considered necessary in the circumstances. The independent public <br />accountant's attestation report should be submitted with this reporting form. <br />Note: Associations with assets or liabilities $200,000 or more must furnish <br />statements prepared in accordance with generally accepted accounting principles <br />(including footnote disclosures). (See Auditor's Packet furnished to Relief <br />Associations for Sample Opinion and Note Disclosures). <br />Has the independent public accountant's attestation report been submitted with this <br />reporting form? Yes If not, please explain: <br />Name of independent public accountant: David J. Mot <br />Address of independent public accountant: 4810 White Rear Parkway, 'Mlhito Bear Lake, "'N 55110 <br />Page 22 <br />