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Randolph County                                                                                                                     Bid 07-1001

Due Date:  Thursday, October 25, 2007, 3:00P.M.                                                         EMS Ambulances

_____________________________________________________________________________________

Appendix A – EXCEPTION FORM

Section Number

Explanation

SignatureDate

Print Name

Title

Company

Address

e-mail

Phone

ANTI-COLLUSION AFFIDAVIT

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