Common use of DECLARATION UNDER PENALTY OF PERJURY Clause in Contracts

DECLARATION UNDER PENALTY OF PERJURY. I understand that I am required to pennit the City of Los Angeles access to and upon request, must provide certified copies of all company records pertaining to benefits, policies and practices for the purpose of investigation or to ascertain compliance with the Equal Benefits Ordinance. Furthermore, I understand that failure to comply may be deemed a material breach of any City contract by the Awarding Authority; the Awarding Authority may cancel, terminate or suspend in whole or in part, the contract; monies due or to become due under a contract may be retained by the City until compliance is achieved. The City may also pursue any and all other remedies at law or in equity for aity breach. The City may use the failure to comply with the Equal Benefits Ordinance as evidence against the Contractor in actions taken pursuant to the provisions of the Los Angeles Administrative Code Section 10.40, et seq., Contractor Responsibility Ordinance. Beacon Solar 3, LLC will comply with the Equal Benefits Ordinance requirements Company Name as indicated above prior to executing a contract with the City' of Los Angeles and will comply for the entire duration of the contracts). I declare under penalty ofpeijury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually. Exeette ire m in the year 20 16 , at Salt Lake City UT (City) (State) 0000 Xxxxx 0000 Xxxx, Xxxxx 000 . - Mailing Address Xxxx Xxxxxxx Name of Signatory (please print) Authorized Person Xxxx Xxxx Xxxx, Xxxx 00000 . City, State, Zip Coda 00-0000000 Title EJN/TIN Form OCC/EBO-Affidavit 2 CITY OF LOS ANGELES PLEDGE OF COMPLIANCE WITH CONTRACTOR RESPONSIBILITY ORDINANCE Los Angeles Administrative Code (LAAC) Section 10.40 et seq. (Contractor Responsibility Ordinance) provides that, unless specifically exempt, City contractors working under service contracts of at least $25,000 and three months, contracts for services and for purchasing goods and products that involve a value in excess of twenty-five thousand dollars ($25,000) and a term in excess of three months are covered by this Article; and construction contracts of any amount; public lessees; public licensees; and certain recipients of City financial assistance or City grant funds, shall comply with ail applicable provisions of the Ordinance, Upon award of a City contract, public lease, public license, financial assistance or grant, the contractor, public lessee, public licensee, City financial assistance recipient, or grant recipient, and any its subcontractors), shall submit this Pledge of Compliance to the awarding authority. The contractor agrees to comply with the Contractor Responsibility Ordinance and the following provisions:

DECLARATION UNDER PENALTY OF PERJURY. I understand that I am required to pennit permit the City of Los Angeles access to and upon request, must provide certified copies of all company records pertaining to benefits, policies and practices for the purpose of investigation or to ascertain compliance with the Equal Benefits Ordinance. Furthermore, I understand that failure to comply with LAAC Section 10.8.2.1 et seq., Equal Benefits Ordinance may be deemed a material breach of any City contract by the Awarding Authority; the . The Awarding Authority may cancel, terminate or suspend in whole or in part, the contract; monies due or to become due under a contract may be retained by the City until compliance is achieved. The City may also pursue any and all other remedies at law or in equity for aity any breach. The City may use the failure to comply with the Equal Benefits Ordinance as evidence against the Contractor in actions taken pursuant to the provisions of the Los Angeles Administrative Code LAAC Section 10.40, et seq., Contractor Responsibility Ordinance. Beacon Solar 3, LLC will 'PorC.Z./ J (C£f'LnC'N\W comply with the Equal Benefits Ordinance requirements Company Name as indicated above prior to executing a contract with the City' City of Los Angeles and will comply for the entire duration of the contractsofthe contract(s). I declare under penalty ofpeijury ofperjury under the laws of the ofthe State of California that the foregoing is true tine and correct, and that I am authorized to bind this this, entity contractually. Exeette ire m Executed flais ^ of. in the year 20 16 , at Salt Lake City UT 00 |x»xx /Xxxxxx'xx ,X± (City,Xxxx„,) (State) 0000 Xxxxx 0000 Xxxx, Xxxxx 000 . - ■pTT' 1JS- H o ri-HooTM Y fgnrture Mailing Address Xxxx Xxxxxxx JT. M«7/ e r~ Name of Signatory (please print) Authorized Person Xxxx Xxxx Xxxx, Xxxx 00000 . Aps £>ec* erfays Lftufsv/i'Mt k.y h *>2.13 City, State, Zip Coda 00-0000000 Title EJN/TIN Form OCC/EBO-Affidavit 2 CITY OF LOS ANGELES PLEDGE OF COMPLIANCE WITH CONTRACTOR RESPONSIBILITY ORDINANCE Los Angeles Administrative Code (LAAC) Section 10.40 et seq. (Contractor Responsibility Ordinance) provides that, unless specifically exempt, City contractors working under service contracts of at least $25,000 and three months, contracts for services and for purchasing goods and products that involve a value in excess of twenty-five thousand dollars ($25,000) and a term in excess of three months are covered by this Article; and construction contracts of any amount; public lessees; public licensees; and certain recipients of City financial assistance or City grant funds, shall comply with ail applicable provisions of the Ordinance, Upon award of a City contract, public lease, public license, financial assistance or grant, the contractor, public lessee, public licensee, City financial assistance recipient, or grant recipient, and any its subcontractors), shall submit this Pledge of Compliance to the awarding authority. The contractor agrees to comply with the Contractor Responsibility Ordinance and the following provisions:*

DECLARATION UNDER PENALTY OF PERJURY. I understand that I am required to pennit permit the City of Los Angeles access to and upon request, must provide certified copies of all company records pertaining to benefits, policies and practices for the purpose of investigation or to ascertain compliance with the Equal Benefits Ordinance. Furthermore, I understand that failure to comply with LAAC Section 10.8.2.1 et seq., Equal Benefits Ordinance may be deemed a material breach of any City contract by the Awarding Authority; the . The Awarding Authority may cancel, terminate or suspend in whole or in part, the contract; monies due or to become due under a contract may be retained by the City until compliance is achieved. The City may also pursue any and all other remedies at law or in equity for aity any breach. The City may use the failure to comply with the Equal Benefits Ordinance as evidence against the Contractor in actions taken pursuant to the provisions of the Los Angeles Administrative Code LAAC Section 10.40, et seq., Contractor Responsibility Ordinance. Beacon Solar 3, LLC will Vt N /ti /nfcrtMyWill comply with the Equal Benefits Ordinance requirements Company Name • as indicated above prior to executing a contract with the City' City of Los Angeles and will comply for the entire duration of the contracts). I declare under penalty ofpeijury of perjury under the laws of the ofthe State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually. Exeette ire m Executed thi: day of JiQ wK&v- in the year 20 16 1 Co , at Salt Lake City UT (City) (State) 0000 Xxxxx 0000 Xxxx, Xxxxx 000 . - [jiW'uJA I 1C CL Signature Mailing Address Xxxx Xxxxxxx Name of Signatory (please print) Authorized Person Xxxx Xxxx Xxxx, Xxxx 00000 . City, State, Zip Coda 00Code Lj v ) W2. L V/v-0000000 Title EJNiA (for-u.«r 1332-13123 EIN/TIN TLN Form OCC/LAWA EBO-Affidavit Affidovit (Rev 5/20/13) 2 CITY OF LOS ANGELES PLEDGE OF COMPLIANCE WITH CONTRACTOR RESPONSIBILITY ORDINANCE Los Angeles Administrative Code (LAAC) Section 10.40 et seqFirst Source Hiring FIRST SOURCE HIRING PROGRAM Pursuant to Resolution No. (Contractor Responsibility Ordinance) provides that22674 adopted by Board of Airport Commissioners on April 18, unless specifically exempt2005, City contractors working under service contracts of at least $25,000 any contract awarded July 1, 2005 and three months, contracts for services and for purchasing goods and products that involve a value in excess of twenty-five thousand dollars ($25,000) and a term in excess of three months are covered by this Article; and construction contracts of any amount; public lessees; public licensees; and certain recipients of City financial assistance or City grant funds, thereafter shall comply with ail be subject to the applicable provisions of the OrdinanceFirst Source Hiring Program (FSHP) for LAX airport jobs. This program will provide early access to targeted applicants for available LAX airport jobs, Upon award and employers will receive prompt, cost-free referrals of a City contractqualified and trained applicants. All Contractors, public leaseLessees, public licenseLicensees, financial assistance and Construction Contractors with non-trade jobs, with new, amended, or grantrenewed contracts will be required to participate in this program. As such, the contractorFSHP will be incorporated as a material term of all LAX airport contracts, public lesseelease agreements and licensing or permitting agreements. LAX employers with open non-construction positions must contact the FSHP, public licensee, City financial assistance recipient, or grant recipient, register their company and any its subcontractors), shall submit this Pledge of Compliance post their positions on the Applicant Tracking System (ATS) prior to posting their positions to the awarding authoritygeneral public. The contractor agrees Failure to comply with the Contractor Responsibility Ordinance this contract provision may result in liquidated damages of $1,000.00. For additional information regarding First Source Hiring Program please contact: Business and Job Resources Center, First Source Hiring Program, 0000 X. Xxxxxxx Xxxx., 0xx Xxxxx, Xxx Xxxxxxx, XX 00000, (000) 000-0000, (000) 000-0000 fax., web: xxx.xxxx.xxx/xxxx. Insurance INSURANCE REQUIREMENTS FOR LOS ANGELES WORLD AIRPORTS NAME: AGREEMENT / ACTIVITY: TERM: VIRGIN ATLANTIC AIRWAYS, LTD. Lease of lounge space in Terminal 2 at LAX LAWA DIVISION: Commercial Development Group The insured must maintain insurance coverage at limits normally required of its type operation; however, the following provisions:coverage noted with an "X" is the minimum required and must be at least the level of the limits indicated. All limits are per occurrence unless otherwise specified. in Workers' Compensation (Statutory)/Employer’s Liability

DECLARATION UNDER PENALTY OF PERJURY. I understand that I am required to pennit permit the City of Los Angeles access to and upon request, must provide certified copies of all company records pertaining to benefits, policies and practices for the purpose of investigation or to ascertain compliance with the Equal Benefits Ordinance. Furthermore, I understand that failure to comply may be deemed a material breach of any City contract by the Awarding Authority; the Awarding Authority may cancel, terminate or suspend in whole or in part, the contract; monies due or to become due under a contract may be retained by the City until compliance is achieved. The City may also pursue any and all other remedies at law or in equity for aity any breach. The City may use the failure to comply with the Equal Benefits Ordinance as evidence against the Contractor in actions taken pursuant to the provisions of the Los Angeles Administrative Code Section 10.40, et seq., Contractor Responsibility Ordinance. Beacon Solar 3, LLC will comply with the Equal Benefits Ordinance requirements Company Name as indicated above prior to executing a contract with the City' City of Los Angeles and will comply for the entire duration of the contractscontract(s). I declare under penalty ofpeijury of perjury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually. Exeette ire m Executed this day of , in the year 20 16 , at Salt Lake City UT , (City) (State) 0000 Xxxxx 0000 Xxxx, Xxxxx 000 . - Signature Mailing Address Xxxx Xxxxxxx Name of Signatory (please print) Authorized Person Xxxx Xxxx Xxxx, Xxxx 00000 . City, State, Zip Coda 00-0000000 Code Title EJNEIN/TIN Form OCC/EBO-Affidavit 2 CITY OF LOS ANGELES PLEDGE OF COMPLIANCE WITH CONTRACTOR RESPONSIBILITY ORDINANCE Los Angeles Administrative Code (LAAC) Section 10.40 et seq. (Contractor Responsibility Ordinance) provides that, unless specifically exempt, City contractors working under service contracts of at least $25,000 and three months, contracts for services and for purchasing goods and products that involve a value in excess of twenty-five thousand dollars ($25,000) and a term in excess of three months are covered by this Article; and construction contracts of any amount; public lessees; public licensees; and certain recipients of City financial assistance or City grant funds, shall comply with ail all applicable provisions of the Ordinance, . Upon award of a City contract, public lease, public license, financial assistance or grant, the contractor, public lessee, public licensee, City financial assistance recipient, or grant recipient, and any its subcontractorssubcontractor(s), shall submit this Pledge of Compliance to the awarding authority. The contractor agrees to comply with the Contractor Responsibility Ordinance and the following provisions:

DECLARATION UNDER PENALTY OF PERJURY. I understand that I am required to pennit permit the City of Los Angeles access to and upon request, must provide certified copies of all company records pertaining to benefits, policies and practices for the purpose of investigation or to ascertain compliance with the Equal Benefits Ordinance. Furthermore, I understand that failure to comply with LAAC Section 10.8.2,1 et seq,. Equal Benefits Ordinance may be he deemed a material breach of any City contract by the Awarding Authority; the , The Awarding Authority may cancel, terminate or suspend in whole or in part, the contract; monies due or to become due under a contract may be retained by the City until compliance is achieved. , The City may also pursue any and all other remedies at law iaw or in . equity for aity any breach. , The City may use the failure to comply with the Equal Benefits Ordinance as evidence against the Contractor in actions taken pursuant to the provisions of the Los Angeles Administrative Code LAAC Section 10.40, 10,40,. et seq., Contractor Responsibility Ordinance. Beacon Solar 3, LLC Company Name will comply with the Equal Benefits Ordinance requirements Company Name as indicated above prior to executing a contract with the City' City of Los Angeles and will comply for the entire duration of the contractscontract(s). I declare under penalty ofpeijury of perjury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually. Exeette ire m Executed this day of j in the year 20 16 , at Salt Lake City UT 20_ .> aL (City) (State) 0000 Xxxxx 0000 Xxxx, Xxxxx 000 Signature . - Mailing Address Xxxx Xxxxxxx Name of Signatory (please print) Authorized Person Xxxx Xxxx Xxxx, Xxxx 00000 . City, State, Zip Coda 00-0000000 Code Title EJN/TIN Form OCC/EBO-Affidavit 2 CITY OF LOS ANGELES PLEDGE OF COMPLIANCE WITH CONTRACTOR RESPONSIBILITY ORDINANCE Los Angeles Administrative Code (LAACRev 6/21/12) Section 10.40 et seq. (Contractor Responsibility Ordinance) provides that, unless specifically exempt, City contractors working under service contracts of at least $25,000 and three months, contracts for services and for purchasing goods and products that involve a value in excess of twenty-five thousand dollars ($25,000) and a term in excess of three months are covered by this Article; and construction contracts of any amount; public lessees; public licensees; and certain recipients of City financial assistance or City grant funds, shall comply with ail applicable provisions of the Ordinance, Upon award of a City contract, public lease, public license, financial assistance or grant, the contractor, public lessee, public licensee, City financial assistance recipient, or grant recipient, and any its subcontractors), shall submit this Pledge of Compliance to the awarding authority. The contractor agrees to comply with the Contractor Responsibility Ordinance and the following provisions:EIN/T1N

DECLARATION UNDER PENALTY OF PERJURY. I understand that I am required to pennit permit the City of Los Angeles access to and upon request, must provide certified copies of all company records pertaining to benefits, policies and practices for the purpose of investigation or to ascertain compliance with the Equal Benefits Ordinance. Furthermore, I understand that failure to comply may be with LAAC Section 10.8.2.1 et seq., Equal Benefits Ordinance maybe deemed a material breach of any City contract by the Awarding Authority; the . The Awarding Authority may cancel, terminate or suspend in whole or in part, the contract; monies due or to become due under a contract may be retained by the City until compliance is achieved. The City may also pursue any and all other remedies at law or in equity for aity any breach. The City may use the failure to comply with the Equal Benefits Ordinance as evidence against the Contractor in actions taken pursuant to the provisions of the Los Angeles Administrative Code LAAC Section 10.40, et seqsea., Contractor Responsibility Ordinance. Beacon Solar 3, LLC ' Company Name L­ will comply with the Equal Benefits Ordinance requirements Company Name as indicated above prior to executing a contract with the City' City of Los Angeles and will comply for the entire duration of the contractscontract(s). I declare under penalty ofpeijury of perjury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually. Exeette ire m . ExeCutedThis day of , in the year 20 16 Ill . atJfoH(W , at Salt Lake City UT (City) (State) 0000 Xxxxx 0000 Xxxx, Xxxxx 000 . - Mailing Address Xxxx Xxxxxxx ik\ 2^ Signature "Phil'Tori d Name of Signatory (please print) Authorized Person Xxxx Xxxx v , (City) A (State) Xxxxxxx Xxxxxxx , Xx 0x0>0 Xxxx, Xxxx 00000 . City, StateXxxxx, Zip Coda 00-0000000 Code Title EJNEIN/TIN Form OCC/EBO-Affidavit 2 CITY OF LOS ANGELES PLEDGE OF COMPLIANCE WITH CONTRACTOR RESPONSIBILITY ORDINANCE Los Angeles Administrative Code (LAAC) Section 10.40 et seq. (Contractor Responsibility Ordinance) provides that, unless specifically exempt, City contractors working under service contracts of at least $25,000 and three months, contracts for services and for purchasing goods and products that involve a value in excess of twenty-five thousand dollars ($25,000) and a term in excess of three months are covered by this Article; and construction contracts of any amount; public lessees; public licensees; and certain recipients of City financial assistance or City grant funds, shall comply with ail applicable provisions of the Ordinance, Upon award of a City contract, public lease, public license, financial assistance or grant, the contractor, public lessee, public licensee, City financial assistance recipient, or grant recipient, and any its subcontractors), shall submit this Pledge of Compliance to the awarding authority. The contractor agrees to comply with the Contractor Responsibility Ordinance and the following provisions:TIN

DECLARATION UNDER PENALTY OF PERJURY. I understand that I am required to pennit permit the City of Los Angeles access to and upon request, must provide certified copies of all company records pertaining to benefits, policies and practices for the purpose of investigation or to ascertain compliance with the Equal Benefits Ordinance. Furthermore, I understand that failure to comply with LAAC Section 10.8.2.1 et seq., Equal Benefits Ordinance may be deemed a material breach of any City contract by the Awarding Authority; the . The Awarding Authority may cancel, terminate or suspend in whole or in part, the contract; monies due or to become due under a contract may be retained by the City until compliance is achieved. The City may also pursue any and all other remedies at law or in equity for aity any breach. The City may use the failure to comply with the Equal Benefits Ordinance as evidence against the Contractor in actions taken pursuant to the provisions of the Los Angeles Administrative Code LAAC Section 10.40, et seq., Contractor Responsibility Ordinance. Beacon Solar 3, LLC will o /s comply with the Equal Benefits Ordinance requirements Company Name as indicated above prior to executing a contract with the City' City of Los Angeles and will comply for the entire duration of the contractsofthe contract(s). I declare under penalty ofpeijury of peijury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually. Exeette ire m Executed this ax day of ., in the year 20 16 i~*l , at Salt Lake City UT at. (City) (State^ IState) 0000 Xxxxx 0000 Xxxx, Xxxxx 000 . - Mailing Address Xxxx Xxxxxxx Signal Name of Signatory (please print) Authorized Person Xxxx Xxxx Mailing Xxxxxxx \/x>X XX 0>x °xxX^ Xxxx, Xxxx 00000 . City, StateXxxxx, Zip Coda 00-0000000 Code Title EJNEIN/TIN Form OCC/EBO-Affidavit 2 CITY OF LOS ANGELES PLEDGE OF COMPLIANCE WITH CONTRACTOR RESPONSIBILITY ORDINANCE Los Angeles Administrative Code (LAAC) Section 10.40 et seq. (Contractor Responsibility Ordinance) provides that, unless specifically exempt, City contractors working under service contracts of at least $25,000 and three months, contracts for services and for purchasing goods and products that involve a value in excess of twenty-five thousand dollars ($25,000) and a term in excess of three months are covered by this Article; and construction contracts of any amount; public lessees; public licensees; and certain recipients of City financial assistance or City grant funds, shall comply with ail applicable provisions of the Ordinance, Upon award of a City contract, public lease, public license, financial assistance or grant, the contractor, public lessee, public licensee, City financial assistance recipient, or grant recipient, and any its subcontractors), shall submit this Pledge of Compliance to the awarding authority. The contractor agrees to comply with the Contractor Responsibility Ordinance and the following provisions:TIN