Common use of Special Certification Clause in Contracts

Special Certification. The individual or officer signing this Agreement certifies by his or her signature that he or she is authorized to sign this Agreement on behalf of the responsible governing board, official, or contractor. PROVIDER further acknowledges that they have reviewed MSHN's MSHN-SUDSP MANUAL. By: Its: Chief Executive Officer Printed Name:_▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Date: By: Its: Printed Name:_ Date: 1) Annual Plan Guidelines: PROVIDER will comply with the requirements of the Annual Plan Guidelines communicated to PROVIDER by MSHN. 2) MSHN-SUDSP MANUAL: PROVIDER will comply with all requirements and procedures contained within the MSHN-SUDSP Manual, which is incorporated into this agreement by reference and made a part hereof.

Special Certification. The individual or officer signing this Agreement certifies by his or her signature that he or she is authorized to sign this Agreement on behalf of the responsible governing board, official, or contractor. PROVIDER further acknowledges that they have it has reviewed and agrees to MSHN's MSHN-SUDSP MANUAL. By: Its: Chief Executive Officer Printed Name:_▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Date: By: Its: Printed Name:_ Date:MSHN «PROVIDER» 1) . Annual Plan Guidelines: PROVIDER will comply with the requirements of the Annual Plan Guidelines communicated to PROVIDER by MSHN. The Annual Plan can be found on MSHN website. 2) . MSHN-SUDSP MANUAL: PROVIDER will comply with all requirements and procedures contained within the MSHN-SUDSP Manual, which is incorporated into this agreement by reference and made a part hereof.

Special Certification. The individual or officer signing this Agreement certifies by his or her signature that he or she is authorized to sign this Agreement on behalf of the responsible governing board, official, or contractor. PROVIDER further acknowledges that they have it has reviewed and agrees to MSHN's MSHN-SUDSP MANUAL. By: Its: Chief Executive Officer Printed Name:_: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Date: 9.23.24 By: Its: Printed Name:_ : Date: 1) . Annual Plan Guidelines: PROVIDER will comply with the requirements of the Annual Plan Guidelines communicated to PROVIDER by MSHN. 2) . MSHN-SUDSP MANUAL: PROVIDER will comply with all requirements and procedures contained within the MSHN-SUDSP Manual, which is incorporated into this agreement by reference and made a part hereof.

Special Certification. The individual or officer signing this Agreement certifies by his or her signature that he or she is authorized to sign this Agreement on behalf of the responsible governing board, official, or contractor. PROVIDER further acknowledges that they have reviewed MSHN's MSHN-SUDSP MANUAL. By: By: Its: Its: Chief Executive Officer Printed Name:_ Printed Name:_▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Date: Date: Witness By: Its: Witness By: Its: MSHN Contract Manager Printed Name:_ Printed Name:_ ▇▇▇▇ ▇▇▇▇▇▇▇▇ Date: Date: 1) Annual Plan Guidelines: PROVIDER will comply with the requirements of the Annual Plan Guidelines communicated to PROVIDER by MSHN. 2) MSHN-SUDSP MANUAL: PROVIDER will comply with all requirements and procedures contained within the MSHN-SUDSP Manual, which is incorporated into this agreement by reference and made a part hereof.

Special Certification. The individual or officer signing this Agreement certifies by his or her signature that he or she is authorized to sign this Agreement on behalf of the responsible governing board, official, or contractor. PROVIDER further acknowledges that they have reviewed MSHN's MSHN-SUDSP MANUAL. By: By: Its: Its: Chief Executive Officer Printed Name:_ Printed Name:_▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Date: By: Its: Printed Name:_ Date: 1) Annual Plan Guidelines: PROVIDER will comply with the requirements of the Annual Plan Guidelines communicated to PROVIDER by MSHN. 2) MSHN-SUDSP MANUAL: PROVIDER will comply with all requirements and procedures contained within the MSHN-SUDSP Manual, which is incorporated into this agreement by reference and made a part hereof.

Special Certification. The individual or officer signing this Agreement certifies by his or her signature that he or she is authorized to sign this Agreement on behalf of the responsible governing board, official, or contractor. PROVIDER further acknowledges that they have it has reviewed and agrees to MSHN's MSHN-SUDSP MANUAL. By: Its: Chief Executive Officer Printed Name:_: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Date: By: Its: Printed Name:_ : Date: 1) . Annual Plan Guidelines: PROVIDER will comply with the requirements of the Annual Plan Guidelines communicated to PROVIDER by MSHN. 2) . MSHN-SUDSP MANUAL: PROVIDER will comply with all requirements and procedures contained within the MSHN-SUDSP Manual, which is incorporated into this agreement by reference and made a part hereof.