Common use of Collusion and Acceptance Clause in Contracts

Collusion and Acceptance. The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. In Witness Whereof, Contractor and the Board have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] Alabama Statewide 911 Board By: ___________________________________ By: _________________________________ Printed Name: __________________________ Printed Name: ________________________ Title: _________________________________ Title: ________________________________ Date: _________________________________ Date: ________________________________

Collusion and Acceptance. You MUST have this clause in your contract. It is required by IC 5-22-16-6. THIS SHOULD BE THE FINAL CLAUSE BEFORE THE SIGNATURE PAGE. All contracts, amendments, renewals, addendums, supplements, etc. must include this clause. The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. In Witness Whereof, Contractor and the Board State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] Alabama Statewide 911 Board [State Agency] By: ___________________________________ By: _________________________________ Printed Name: __________________________ Printed Name: ________________________ Title: _________________________________ Title: ________________________________ Date: _________________________________ Date: ________________________________

Collusion and Acceptance. The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorFreeway School, or that the undersigned is the properly authorized representative, agent, member or officer of the ContractorFreeway School. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorFreeway School, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. In Witness Whereof, Contractor Freeway School and the Board State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] Alabama Statewide 911 Board FREEWAY SCHOOL STATE BOARD OF EDUCATION By: ___________________________________ By: _________________________________ Printed Name: __________________________ Printed Name: ________________________ Title: _________________________________ Title: ________________________________ Date: _________________________________ Date: _________________________________ Appendix A