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52 <br /> EXECUTION OF PROPOSAL <br /> PROJECT NAME: <br /> HOUSEHOLD HAZARDOUS WASTE COLLECTIONPROPOSAL REQUEST NO. 236 <br /> THIS PAGE MUST BE FULLY EXECUTED AND SIGNED FOR THE PROPOSAL TO BE CONSIDERED. <br /> The person executing the proposal, onbehaKofthevondnr, beingfirotdulvsvvorn, depooesmndaayathat: <br /> (1) He is fully informed regarding the preparation and contents of the attached Proposal and of all <br /> pertinent circumstances regarding such Proposal; <br /> (2) Neither he, nor any official, agent or employee of the vendor has entered Into any agreement, <br /> participated In any collusion, or otherwise taken any action which Is in restraint of free competition in <br /> connection with this proposal; and <br /> SIGNATURE OF PROPOSAL <br /> Clean Harbors Environmental Services,Inc, <br /> ' (Print full name of corporation) <br /> 208 Watlington Industrial Drive,Reidsville,NC 27320 <br /> j (A dress -County- State-Zip Code) <br /> �r <br /> Attest <br /> (-SaGretaPylAnoi ta t ecretary) David T.Musselman <br /> By: <br /> P -sidentNi ^ PnasA4mmimt'nt Vice President) ' <br /> .".'.../ <br /> Printed: Joseph L.McNally <br /> Title: VP <br /> CD <br /> • CORPORATE SEAL ` <br /> Federal ID. or Social GncurKvNunmbnr 04-269-8999 <br /> , <br /> NOTE-AFF DAVIT MUST BE NOTARIZED <br /> Subscribed and <br /> This 9th 40sayfif_Apri, . '2v/^, <br /> MUSSELMAN <br /> ' Notary Public <br /> cvmrviuwxox000FmAo^cxoSEnx / <br /> My Commission Expires / <br /> u°p|emuerl5. «»//--� <br /> Title <br /> My Commission <br /> \ ' <br /> Page 17 <br /> HHW RFP#m83 <br />