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This bids made in accordance with and subject to the terms and conditions set <br />forth in the Invitation for Bids. <br /> <br />~rinted Name(s) of Bidder(s) <br /> <br />Signature(s) of Bidder(s) or of <br />Authorized Officer(s) or Agent(s) <br />of Bidder(s) <br /> <br />FOR INFORMATION ONLY <br />(Not part of Bid) <br /> <br />Gross Interest Cost ............. <br />Less Premium (if any) ...... <br />Net Interest Cost ........... <br />Net Interest Rate . ' ........ <br />Purchase Price (excl&siv& ~f'a~y'p~e~i~ ......... <br />and accrued interest) as a percentage <br />of par value ..................... <br /> <br />$ <br />$ <br />$ <br /> <br />196/14:~8ZALA. 81D <br /> <br />-7- <br /> <br /> <br />