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PART D <br /> CITY OF ST. ANTHONY, MINNESOTA <br /> PROPOSAL FOR INSURANCE <br /> AFFIDAVIT OF INSURANCE AGENT <br /> 1982 INSURANCE BID <br /> STATE OF MINNESOTA <br /> COUNTY OF <br /> being duly sworn , .upon oath, deposes <br /> and says that: <br /> 1 . Affiant resides in <br /> 2. Affiant is personally licensed by the State of Minnesota to sell all lines of <br /> insurance upon which affiant has submitted bids. <br /> 3. Affiant , with respect to all lines of insurance upon which a bid has been <br /> • submitted, represents an insurance company licensed to do business in the <br /> State of Minnesota and which has an agent and a resident claim manager in <br /> the State of Minnesota. <br /> 4. Affiant makes this Affidavit stating that the previous statements are true <br /> as part of a bid for insurance to be purchased by the City of St. Anthony , <br /> Minnesota, as an inducement to the City of St. Anthony, Minnesota, to <br /> accept same. <br /> Signed <br /> Firm Name <br /> Subscribed and sworn to before me this day of 19 <br /> Notary Public <br /> County, Minnesota <br /> My Commission expires 19 <br />