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RFP 111010 <br /> 6.1.B. - Page 46 compliance with federal affirmative action requirements. <br /> Company Name: <br /> Contact Person for Questions: Phone: <br /> (Must be individual who is responsible for filling out this Proposer's Response form) <br /> Address: <br /> City/State/Zip: <br /> Telephone Number: Fax Number: <br /> E-mail Address: <br /> Authorized Signature: <br /> Authorized Name(typed): <br /> Title: <br /> Date: <br /> Notarized <br /> Subscribed and sworn to before me this the day of , 20 <br /> Notary Public in and for the County of State of <br /> My commission expires: <br /> Signature: <br /> Page 43 of 47 <br />