Number Employees Positive. Percent Employees Positive Initials consistent with the Mayor's Policy and Executive Order No. 1-31. Initials with established guidelines will be considered a breach of contract. I declare under penalty of perjury that the affirmations made herein and all information contained in this declaration are within my personal knowledge and are true and correct. (Date) (Typed or Printed Name) (Signature)
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Samples: Professional Services, Group Application, Group Application for Medicare Advantage Ppo and Medicare Part D
Number Employees Positive. Percent Employees Positive Initials worksite consistent with the Mayor's Policy and Executive Order No. 1-31. Initials accordance with established guidelines will be considered a breach of contract. I declare under penalty of perjury that the affirmations made herein and all information contained in this declaration are within my personal knowledge and are true and correct. (Date) (Typed or Printed Name) (Signature)
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Number Employees Positive. Percent Employees Positive Initials consistent with the Mayor's Policy and Executive Order No. 1-31. Initials with established guidelines will be considered a breach of contract. I declare under penalty of perjury that the affirmations made herein and all information contained in this declaration are within my personal knowledge and are true and correct. (Date) (Typed or Printed Name) (Signature)) (Title) During the performance of this Agreement, Contractor, for itself, its assignees and successors in interest agrees as follows:
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