Existing Government Contracts. By signing this Contract, the DESIGNER certifies under the penalties of perjury that the following is a listing of all other existing contracts or income derived by DESIGNER from the Commonwealth or any political subdivision thereof or public authority therein, from the Federal Government or any agency thereof, and from the OWNER or any governmental source for services rendered. [M.G.L. c. 7C, § 48(a)(v)]: Contract Description Present Status % Fee Total Fee & Awarding Authority Design/Construction Received Anticipated
Existing Government Contracts. By signing this Contract, the Designer certifies under the penalties of perjury that the list in Attachment K – Certifications of Designer Made Under Pains and Penalties of Perjury is a listing of all other existing contracts or income derived by Designer from the Commonwealth or any political subdivision thereof or public authority therein, from the Federal Government or any agency thereof, and from the Awarding Authority or any governmental source for services rendered. [M.G.L. c. 7C s. 48]:
Existing Government Contracts. By signing this Contract, the House Doctor certifies under the pains and penalties of perjury that the list in Exhibit M: Beneficial owners, Professional Registrants, Existing Government Contracts is a listing of all other existing contracts or income derived by the House Doctor from the Commonwealth or any political subdivision thereof, or public authority therein, from the Federal Government or any agency thereof, and from Awarding Authority or any governmental source for services rendered [M.G.L. c. 7C s. 48].
Existing Government Contracts. Contract Description Present Status % Fee Total Fee & Awarding Authority Design/Construction Received Anticipated By signing below, I certify on behalf of House Doctor, under the pains and penalties of perjury, that the information in this Exhibit is accurate, complete, and current: House Doctor: By: (duly authorized) Print Name: Date: EXHIBIT N – Corporate Vote or Other Evidence of Authority 20 I hereby certify that I am the clerk, , assistant clerk, managing partner of . (the “Corporation”) and that at a (Name of Corporation/Partnership) duly authorized meeting of the Board of Directors of the Corporation/Partners held on in at which a quorum was (Date) (Location) present and voting it was voted to authorize (Name) of the Corporation/Partnership to (Officer Title) execute and deliver on behalf of the Corporation/Partnership the following contract and to act as principal to execute the contract and make Certifications in connection therewith, which contract and certifications were presented to and made a part of the records of said meeting: Mass State Project No.
Existing Government Contracts. Contract Description Present Status % Fee Total Fee & Awarding Authority Design/Construction Received Anticipated Attachment L – DCAMM Payment Voucher Form (PV) and Instructions ALL DESIGNERS MUST SUBMIT ORIGINAL PAYMENT VOUCHER FORMS OR BILLINGS WILL BE RETURNED FOR CORRECTION • Designer fills in shaded areas. • A duplicate vendor invoice number cannot be used. • All back-up must be submitted in triplicate. Note: Please notify DCAMM if the Designer’s company name or address change from where the checks are normally mailed to. All changes must be done in writing and on original company letterhead and sent to the following address: Division of Capital Asset Management and Maintenance Xxx Xxxxxxxxx Xxxxx, 00xx Floor Boston, MA 02108 Attention: Contract Section Mail all PVs to: The above address Attention: Payment Unit All questions and payment status inquiries should be directed to your DCAMM project engineer or project manager. The PV Form (shown below) may be downloaded at xxxx://xxx.xxxx.xxx/anf/property-mgmt-and- construction/design-and-construction-of-public-bldgs/general-contractors-billing-instructions.html. Designer may call the Payment Unit Vendor Telephone Line at (617) 727 – 4006 ext. 31335 for additional PV forms. THE COMMONWEALTH OF MASSACHUSETTS DIVISION OF CAPITAL ASSET MANAGEMENT AND MAINTENANCE PAYMENT VOUCHER INPUT FORM DOCUMENT ID VENDOR NAME AND ADDRESS FY PAYMENT TYPE (CIRCLE ONE) DEPT UNIT ID NUMBER DATE ACTION: PRC GAX INP DCP E HEADER INFORMATION BUDGET FY FISCAL YEAR PERIOD VENDOR CUSTOMER CODE NO: VENDOR ADDRESS CODE VC DOCUMENT TOTAL MASS STATE PROJECT NO.: VENDOR CERTIFICATION $ - PROJECT DESCRIPTION: I certify that the goods were shipped or the services rendered as set forth below. SCHEDULE PAY DATE LOCATION: INVOICE TOTAL: (Please Sign In Ink) REFERENCE ENCUMBRANCE DOCUMENT INFORMATION Encumbrance Type CT / PC / GAE ENCUMBRANCE DOCUMENT NUMBER Reference Type P or F Vendor Invoice No: Vendor Inv. Line Vendor Inv. Date P COMMODITY INFORMATION Commodity Line # Commodity Code Quantity Unit Price Contract Line Amount Rec'd Service From Date Rec'd Service To Date $ - ACCOUNTING INFORMATION Accounting Line # Event Type Line Amount Unit Appropriation Object Function Location Program Code Budget Code $ - TO THE COMPTROLLER OF THE COMMONWEALTH OF MASSACHUSETTS:I hereby certify under the penalties of perjury that all laws of the Commonwealth governing disbursements of public funds and the regulations thereof have been complied with and ob...
Existing Government Contracts. By signing this Contract, the CONSULTANT certifies under the penalties of perjury that the following is a listing of all other existing contracts or income derived by CONSULTANT from the Commonwealth or any political subdivision thereof or public authority therein, from the Federal Government or any agency thereof, and from the OWNER or any governmental source for services rendered. Contract Description Present Status % Fee Total Fee & Awarding Authority Design/Construction Received Anticipated The CONSULTANT agrees to update this list upon the signing of each Project Agreement
Existing Government Contracts. As of the Closing Date, Consultant is currently a party to certain government contracts described in Exhibit A ("Existing Government Contracts") which involve the use of the specific Intellectual Property and Related Materials identified in Exhibit A ("Existing Government Contracts"). Immersion hereby grants Consultant a limited license to use, and have in Consultant's possession, such Intellectual Property and Related Materials solely within the scope of such government contracts and to the extent required by such government contracts and only for the term of such government contracts. Consultant agrees to promptly return all such Intellectual Property and Related Materials, including any copies thereof, upon termination or expiration of such government contracts. In addition, to the extent that Consultant's force feedback research activities under such Existing Government Contracts result in the creation of additional intellectual property rights relating to the Intellectual Property and Related Materials, Consultant grants Immersion a non-exclusive license to all such intellectual property rights arising from the ongoing force feedback research activities.
Existing Government Contracts. By signing this Agreement, the Consultant certifies under the pains and penalties of perjury that the list in Exhibit H: Beneficial Owners, Professional Registrants, Existing Government Contracts is a listing of all other existing contracts or income derived by the Consultant from the Commonwealth or any political subdivision thereof, or public authority therein, from the Federal Government or any agency thereof, and from Awarding Authority or any governmental source for services rendered.(M.G.L. c. 7C s. 48)
Existing Government Contracts. Contract Description Present Status % Fee Total Fee & Awarding Authority Design/Construction Received Anticipated By signing below, I certify on behalf of Consultant, under the pains and penalties of perjury, that the information in this Exhibit is accurate, complete, and current: Consultant: By: (duly authorized) Print Name: Date: Massachusetts Water Resources Authority Consultant Disclosure Statement (CDS) Version: October 2011 If this is an annual filing, complete Sections 1 & 2. If your firm is either the prime consultant or a subconsultant on a team that is first ranked, check the basis of compensation for your new contract and complete the applicable sections for your firm. The prime consultant is responsible to ensure that each of its subconsultants submit its own form. If your firm has been first ranked for a new contract, and has a current annual CDS on file, please check off the block below, sign the certification, and provide only the additional or changed information required. This CDS should be submitted to the Internal Audit Department of the MWRA at 000 0xx Xxxxxx, Xxxxxx, XX 00000. Reason for Submittal (check) Annual Filing First Ranked (Specify Project Name & Contract Number) Current annual CDS already on file Basis for Compensation (check) Complete Sections Lump Sum Cost Plus Fixed/Percentage Fee (CPFF/CPPF) Multiplier Single Hourly Rate (SHR) Unit Price Other 1 & 2 1 & 2 1, 2 & 3 1 & 3 1 & 3 1, 2 & 3
Existing Government Contracts. Contract Description Present Status % Fee Total Fee & Awarding Authority Design/Construction Received Anticipated By signing below, I certify on behalf of Consultant, under the pains and penalties of perjury, that the information in this Exhibit is accurate, complete, and current: Consultant: By: (duly authorized) Print Name: Date: RFQ/P ATTACHMENT C CERTIFICATION Minimum Standards for Child Care Tuition Assistance and On-Site or Near-Site Subsidized Child Care Placements. Chapter 521 of the Acts of 1990 as amended by Chapter 329 of the Acts of 1991 (102 Code of Massachusetts Regulations 12.00) MWRA Contract No. Contract Title: .
