Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXX, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _____________________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor_______________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-1
Appears in 3 contracts
Samples: Service Order Contract, Service Order Contract, Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXX:BARNEY & WORTH, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _________INC By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor[Print Name Here] Title:_________________________________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 2 contracts
Samples: Service Order Contract, Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXPLANK ROAD SOLULTIONS, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _________LLC By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor[Print Name Here] Title: ____Member__________________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 2 contracts
Samples: Service Order Contract, Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXXXXXXX, an Individual individual d/b/a Xxxxx Xxxxxxxxxx Artemis Consulting _____________________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole ProprietorXxxxxx Title: ____Sole Proprietor___________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXPRR, an Individual d/b/INC., a Xxxxx Xxxxxxxxxx Consulting _________Washington corporation By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor[Print Name Here] Title:_________________________________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: THE XXXX XXXXX XXXXXXXXXXCOMPANY, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _LLC By: ____________________________________________________ Xxxx Xxxxx Xxxxxxxxxx Title:______Sole ProprietorTitle: Owner / Manager___________________________ Date:__________________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXIN-ACCORD, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _________INC. By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor[Print Name Here] Title:_________________________________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXINSTITUTE FOR CONFLICT MANAGEMENT, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _________INC. By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor[Print Name Here] Title:_________________________________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXXxxx Xxxxx, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _____Mediation ________________________________________________ Xxxx Xxxxx Xxxxxxxxxx Title:______Sole ProprietorTitle: _____Sole Proprietor___________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXTRIANGLE ASSOCIATES, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _________INC. By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor[Print Name Here] Title:_________________________________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXXXXXXX & WEST, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _________INC. By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor[Print Name Here] Title:_________________________________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXX3J Consulting, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _________Inc. By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor[Print Name Here] Title:_________________________________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXX, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting ________XXXXXX XXXX _____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Xxxxxx Xxxx, an individual Title:___Sole Proprietor_______________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-116
Appears in 1 contract
Samples: Service Order Contract
Tax ID Accurate. The Contractor tax identification numbers provided to Agency under Section 5.5.1 of this SOC are true and accurate. CONTRACTOR: XXXXX XXXXXXXXXXXXXXXXX XXXXXX CONSULTING, an Individual d/b/a Xxxxx Xxxxxxxxxx Consulting _________LLC By:____________________________________________ Xxxxx Xxxxxxxxxx Title:______Sole Proprietor_____Xxxxxxx Xxxxxx Title:____Owner-Manager__________________ Date:_____________________________________________ AGENCY:_______________________________________ (include here division or section as well, if applicable) By:____________________________________________ [Print Name Here] Title:_________________________________________ Date:________________________________________ Approved for Legal Sufficiency: (Required if contract amount is $150,000 or greater) ________________________________________________ Authorized Signature ________________________________________________ Printed Name Title: Assistant Attorney General DOJ Matter No. GF0037-1(Required if contract amount is $150,000 or greater)
Appears in 1 contract
Samples: Service Order Contract