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4) At the time such (goods/merchandise /equipment/services) were furnished to the city, <br />I had the following personal financial interest in this contract: (specify the nature of the <br />personal financial interest) <br />To the best of my knowledge and belief, the contract price is as low as, or lower than the price at <br />which the (goods / merchandise / equipment / services) could be obtained from other sources. <br />I further state that this affidavit constitutes a claim against the city for the contract price, that the <br />claim is just and correct, and that no part of the claim has been paid. <br />(signature of interested official) <br />Subscribed and sworn to before me this day of (month) (year). <br />(signature of notary) <br />League of Minnesota Cities Information Memo: 10/17/2014 <br />Official Conflict of Interest Page 41 <br />