BACKGROUND AND EXPERIENCE CERTIFICATION FORM Sample Clauses

BACKGROUND AND EXPERIENCE CERTIFICATION FORM. The undersigned, having read all the specifications contained herein certifies the following: I, am the of (Authorized Representative’s Name) (Title) hereinafter “Vendor,” and am legally authorized to (Vendor’s Company Name) represent and bind the Vendor and have personal knowledge of the information provided below. I hereby certify that the following information is true and correct to the best of my knowledge: Provide brief description of company: Company incorporation date: Provide brief background of company: How many years of IV&V experience does the company have? (Check one) Up to 3 years IV&V experience  10 plus years IV&V experience  AUTHORIZED SIGNATURE COMPANY NAME ATTACHMENT C RESPONSIBLE VENDOR REVIEW FORM Respondent Name: Respondent Address: Vendors are required to answer the questions set forth below, and for each “YES” answer provide a detailed, written explanation (in Section One of its Response) relevant to each “YES” answer and attach copies of documents relevant to written explanation(s) provided. The undersigned, as an authorized representative of the above-named Respondent, having direct knowledge of the legal affairs and contractual relationships and responsibilities of Respondent, hereby attests to the accuracy of the following information:
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Related to BACKGROUND AND EXPERIENCE CERTIFICATION FORM

  • Drug-Free Workplace Certification As required by Executive Order No. 90-5 dated April 12, 1990, issued by the Governor of Indiana, the Contractor hereby covenants and agrees to make a good faith effort to provide and maintain a drug-free workplace. The Contractor will give written notice to the State within ten (10) days after receiving actual notice that the Contractor, or an employee of the Contractor in the State of Indiana, has been convicted of a criminal drug violation occurring in the workplace. False certification or violation of this certification may result in sanctions including, but not limited to, suspension of contract payments, termination of this Contract and/or debarment of contracting opportunities with the State for up to three (3) years. In addition to the provisions of the above paragraph, if the total amount set forth in this Contract is in excess of $25,000.00, the Contractor certifies and agrees that it will provide a drug-free workplace by:

  • Form of Compliance Certificate For the fiscal quarter ended , 20 . I, , [Title] of SILICON LABORATORIES INC. (the “Borrower”) hereby certify that, to the best of my knowledge and belief, with respect to that certain Credit Agreement dated as of July 31, 2012 (as amended, modified, restated or supplemented from time to time, the “Credit Agreement”; all of the defined terms in the Credit Agreement are incorporated herein by reference) among the Borrower, the Guarantors, the Lenders and Wxxxx Fargo Bank, National Association (successor to Bank of America, N.A., the original administrative agent), as the Administrative Agent: The company-prepared financial statements which accompany this certificate are true and correct in all material respects and have been prepared in accordance with GAAP applied on a consistent basis, except as otherwise expressly noted therein, subject to the absence of footnotes and to normal year-end audit adjustments. As of the date hereof, no Default or Event of Default has occurred and is continuing under the Credit Agreement. (select one): ¨ Attached hereto are such supplements to Schedules 6.13 (Subsidiaries), 6.20(a) (Locations of Real Property), 6.20(b) (Locations of Tangible Personal Property), 6.20(c) (Location of Chief Executive Office, Taxpayer Identification Number, Etc.), and 6.20(d) (Changes in Legal Name, State of Formation and Structure) of the Credit Agreement, such that, as supplemented, such Schedules are accurate and complete as of the date hereof. ¨ No such supplements are required at this time. Delivered herewith are (i) detailed calculations demonstrating compliance by the Loan Parties with the financial covenants contained in Section 8.11 of the Credit Agreement as of the end of the fiscal period referred to above and (ii) detailed calculations demonstrating the Consolidated Leverage Ratio as of the end of the fiscal period referred to above to determine the Applicable Rate. This day of , 20 . SILICON LABORATORIES INC. By: Name: Title: Attachment to Officer’s Certificate Computation of Financial Covenants

  • Financial Condition Certificate The Administrative Agent shall have received a certificate or certificates executed by a Responsible Officer of the Borrower as of the Closing Date, as to certain financial matters, substantially in the form of Exhibit P.

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