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0 <br />6 <br />MINN. <br />STAT. <br />SECTION <br />Part IV. Contract for Less than 15t000 <br />471.88 A. If an interested officer entered into a <br />subd, 5 contract with Oio governing body was the <br />amount involved not in excess of $5,0002 <br />I. Row much in monies or other consider- <br />ation did the interested officer <br />receive from the governing body, during <br />the course of the fiscal year? <br />Name Amount <br />2. If there wan s aeries of contraco <br />between the governing body and the <br />interested officer with a total, <br />amount exceeding $5,000.00, was <br />each contract clearly a separate <br />transaction and no: part of one <br />overall transaction? <br />3. Did the governing body, prior to <br />performance of the contract or contracts, <br />adopt a resolution setting forth the facts <br />and determining that the contract price <br />was as low as or lower than the price that <br />the comodity or service could be obtained <br />elsewhere? <br />4. If the contract vas entered into under <br />emergency conditions, did the governing <br />body adopt such a resolution after or <br />during performance of the came? <br />5. Prior to payment of the contract, did the <br />involved officer Me vith the Clerk of <br />the governing body to affidavit <br />atatiug: <br />A. the name of the officer, and office <br />held; <br />b, an itemisation 0. commodity or <br />aerviees furnished; <br />c. the contract price; <br />d, the reesoneble value; <br />e, the interact of the officer in <br />the contract; and <br />2-4 <br />L'ORRPAPER <br />YES NO REFERENCE <br />