The typed name below represents and warrants that (a) the party below is an authorized representative of the company; and (b) that the information provided herein is a complete and accurate representation of the company's financial situation as of the date hereof. Any misrepresentation or fraudulent information provided will be the basis for default under any agreement. By executing this form, I expressly authorize Avi-Con, Inc. to contact the above references to determine credit worthiness.
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