SIGNATURES AND ACKNOWLEDGEMENT. Public Agency: By: Assistant Secretary, Governing Board XXXXX X. XXXXXXX, Director of Purchasing & Contracts Note to Contractor: (1) Execute acknowledgement form below, and (2) if a corporation, affix Corporate Seal. Contractor hereby also acknowledging awareness of and compliance with Labor Code S1861 concerning Worker's Compensation Law. Contractor: By: (CORPORATE SEAL) (Designate Official Capacity – NAME) Print NAME and TITLE License Number Federal ID Number NOTARY PUBLIC ============================================================================================= STATE OF CALIFORNIA ) ) ss. COUNTY OF CONTRA COSTA ) On , before me, , Notary Public, personally appeared , personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. Witness my hand and official seal. Notary Public [SEAL]
SIGNATURES AND ACKNOWLEDGEMENT. By signing below, the following officials acknowledge that they understand and agree to all of the terms and responsibilities set forth herein and cause this Agreement to be executed. APPROVED FOR Water Provider: Signature Date Print Name /Title APPROVED FOR DWS: Xxxxx Xxxxxxx, Executive Director Date ATTACHMENT A NON-DISCLOSURE AGREEMENT Each Contractor/Grantee employee or volunteer and each Sub-Contractor/Grantee employee or volunteer who has access to Customer personal information must sign this Non-Disclosure Agreement at the beginning of the grant or upon hire. A signed copy of this Agreement must be in each employee’s/volunteer’s file subject to inspection and review by the Department of Workforce Services (DWS). The Contractor/Grantee and its employees and volunteers will comply with the following measures to protect the privacy of the information released under this agreement against unauthorized access or disclosure.
SIGNATURES AND ACKNOWLEDGEMENT. THE PARTIES ACKNOWLEDGE THAT THEY HAVE READ THIS AMENDMENT, UNDERSTAND IT, AND AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS. FURTHER, THE PARTIES AGREE THAT THE COMPLETE AND EXCLUSIVE STATEMENT OF THE AGREEMENT BETWEEN THE PARTIES RELATING TO THIS SUBJECT SHALL CONSIST OF 1) THIS AMENDMENT, 2) THE SCHEDULES AND SUPPLEMENTS TO THE SCHEDULES, AND 3) THE AGREEMENT, DATED FEBRUARY 6, 2001, AS PREVIOUSLY AMENDED. FRANKLIN'S APPROVAL OF THIS AMENDMENT SHALL BE CONSIDERED ACCEPTANCE BY FRANKLIN OF IBM'S PROVISION OF THE SERVICES FOR THE CORRESPONDING CHARGES SPECIFIED IN THE AGREEMENT, AS AMENDED. THIS STATEMENT OF THE AMENDMENT SUPERSEDES ALL PROPOSALS OR OTHER PRIOR AGREEMENTS, ORAL OR WRITTEN, AND ALL OTHER COMMUNICATIONS BETWEEN THE PARTIES RELATING TO THE SUBJECT MATTER DESCRIBED IN THIS AMENDMENT. Accepted by: Accepted by: INTERNATIONAL BUSINESS MACHINES FRANKLIN TEMPLETON COMPANIES, LLC CORPORATION By: /s/ Melody Gayeski By: /s/ Jennifer J. Bolt -------------------- -------------------- Authorized Signature Authorized Signature MELODY GAYESKI Date 2/3/03 JENNIFER J. BOLT Dxxx 0/0/00 -------------- ------ ---------------- ------ Name (Type or Print) Name (Type or Print)
SIGNATURES AND ACKNOWLEDGEMENT. Public Agency, By: _ [edit] Note to Contractor: (1) Execute acknowledgement form below, and (2) if a corporation, affix Corporate Seal. Contractor, hereby also acknowledging awareness of and compliance with Labor Code S1861 concerning Worker's Compensation Law. Contractor: By: (CORPORATE SEAL) (Designate Official Capacity – COMPANY NAME) Print NAME and TITLE _ _ License Number Federal ID Number NOTARY PUBLIC ============================================================================================= State of California )ss. ACKNOWLEDGEMENT (By Corporation, Partnership or Individual) County of Contra Costa ) The person(s) signing above for Contractor, known to me in individual and business capacity as stated, personally appeared before me today and acknowledged that he/she/they executed it and that the corporation or partnership named above executed it. Dated: (NOTARIAL SEAL)
SIGNATURES AND ACKNOWLEDGEMENT. A. By subscription of their signatures below, the Parties represent and warrantthat they are duly authorized to enter into this MOA on behalf of ATF and Pueblo Police Department.
