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This is a draft for approval only, Do Not Sign. Signing will be done in order, by email through DocuSign. <br />1. State Encumbrance Verification <br />Individual certifies that funds have been encumbered as <br />required by Minn. Stat. §§ 16A.15 and 16C.05 <br />Print Name: <br />Signature: <br />Title: <br />SWIFT Contract No. <br />Date: <br />3. State Agency <br />With delegated authority <br />Print Name: <br />Signatu re: <br />Title: <br />Date: <br />2. City 4. Commissioner of Administration <br />As delegated to The Office of State Procurement <br />Print Name: Print Name: <br />Signature: Signature: <br />Title: Date: Title: Date: <br />Admin ID: <br />Print Name: <br />Signatu re: <br />Title: <br />Date: <br />Page 7 of 8 <br />