(Name of person giving the guaranty or undertaking) hereby guarantees that no article listed herein is adulterated or misbranded within the meaning of the Connecticut Food, Drug and Cosmetic Act, or is an article which may not under the provisions of section 21a-103 or 21a-110 of the general statutes, as amended, be introduced into commerce.
(Signature and post-office address of person giving the guaranty or undertaking.)
The article comprising each shipment or other delivery hereafter made by (name of person giving the guaranty or undertaking) to, or on the order of (name and post-office address of person to whom the guaranty or undertaking is given) is hereby guaranteed, as of the date of such shipment or delivery, to be, on such date, not adulterated or misbranded within the meaning of the Connecticut Food, Drug and Cosmetic Act, and not an article which may not, under the provisions of section 21a-103 or 21a-110 of the general statutes, as amended, be introduced into commerce.
(Signature and post-office address of person giving the guaranty or undertaking.)
Conn. Agencies Regs. § 21a-115-4