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We are a scrutinized company as defined in Public Contract Code section 10476, but <br />we have received written permission from the Department of General Services to <br />submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of <br />the written permission from DGS is Included with our bid or proposal. <br />Company/Vendor Name (Printed) <br />By (Authorized Signature) <br />Printed Name and Title of Person Signing <br />Page 2 of 2 ' <br />