Xxxxxxxx’s Affidavit. If requested, Xxxxxxxx has provided Lender with an affidavit in the form attached as Exhibit G.
Xxxxxxxx’s Affidavit Sample Clauses
Related to Xxxxxxxx’s Affidavit
FIRPTA Affidavit A non-foreign affidavit, properly executed and in recordable form, containing such information as is required by IRC Section 1445(b)(2) and its regulations.
AFFIDAVIT The undersigned swear or affirm that the foregoing statements are correct and include all material information necessary to identify and explain the terms and operation of our joint venture and the intended participation by each joint venturer in the undertaking. Further, the undersigned covenant and agree to provide to the County current, complete and accurate information regarding actual joint venture work and the payment therefore and any proposed changes in any of the joint venture. Also, permit authorized representatives of the County to audit and examine records of the joint venture. Any material misrepresentation will be grounds for terminating any contract which may be awarded and for initiating action under Federal or State laws concerning false statements." Name of Firm: Name of Firm: Signature: Signature: Name: Name: Title: Title: Date: Date: INFORMATION FOR DETERMINING JOINT VENTURE ELIGIBILITY – PAGE 4 Date State of County of AFFIDAVIT STATE OF FLORIDA ) ) ss: COUNTY OF ) The foregoing instrument was acknowledged before me by means of ☐ physical presence, or ☐ online notarization, this day of , 20 , by [NAME OF PERSON], as [TYPE OF AUTHORITY,… e.g. officer, trustee, etc.)] for [NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED]. ☐ Personally Known; OR ☐ Produced Identification. Type of identification produced: . [CHECK APPLICABLE BOX TO SATISFY IDENTIFICATION REQUIREMENT OF FLA. STAT. §117.05] Notary Public My Commission Expires: (Printed, typed or stamped commissioned name of Notary Public) ORANGE COUNTY, FLORIDA Procurement Division CONTRACT NO. Y22-1022 SHUTTLE BUS SERVICES FOR OCCC This contract is not valid unless bilaterally executed. Subject to mutual agreement Orange County, Florida, hereby enters into a contract subject to the following:
Form instructions 1. This form does not mandate the use of a specific font size or style but the font must be legible.
Authorised Signatory An authorised signatory is required to sign this Data Sharing Agreement after all recommendations made by the Data Governance Board have been addressed and before the Data Sharing Agreement can be executed. This signatory has the role of accountability for the data sharing defined in this Data Sharing Agreement and holds the post of Principal Officer (equivalent) or above. The Parties hereby agree to their obligations pursuant to this Data Sharing Agreement for the transfer of personal data as described in this Data Sharing Agreement.
Certification of Contractor The Contractor shall certify, over his own signature, that the Work provided for by the Contract Documents has been completed under the terms and conditions thereof, and that the entire balance of the contract is due and payable.
Acknowledgement of Understanding I have read this waiver of liability, assumption of risk, and indemnify, fully understand its terms, and understand that I am giving up my rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to a complete and unconditional release of liability, to the greatest extent allowed by law. Printed Name Signature
Certification instructions You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (XXX), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4. Sign Here Signature of U.S. person ▶ Date ▶ General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an XXX. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to:
Instructions for Certification 1. By signing and submitting this CONTRACT, the prospective lower tier participant is providing the certification set out below.
Certification of Coverage Engineer shall furnish County with a certification of coverage issued by the insurer. Engineer shall not cause any insurance to be canceled nor permit any insurance to lapse. In addition to any other notification requires set forth hereunder, Engineer shall also notify County, within twenty-four (24) hours of receipt, of any notices of expiration, cancellation, non-renewal, or material change in coverage it receives from its insurer.
Authorised Signature (Head Teacher / Deputy) I approve this user to be set-up on the school systems relevant to their role Signature ......................................... Date .........................................
