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:
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 On this AFFIDAVIT day of , 20 , before me appeared (name) , to me personally known, who being duly sworn, did execute the foregoing affidavit, and did state that he or she was properly authorized by (name of firm) to execute the affidavit and did so as his or her free act and deed. Notary Public Commission Expires (Seal) Date State of County of On this day of _ , 20 , before me appeared (name), to me personally known, who being duly sworn, did execute the foregoing affidavit, and did state that he or she was properly authorized by (name of firm) to execute the affidavit and did so as his or her free act and deed. Notary Public Commission Expires (Seal) ORANGE COUNTY BOARD OF Procurement Division COUNTY COMMISSIONERS CONTRACT NO. Y20-158 TEMPORARY LABOR FOR SKILLED GENERAL MAINTENANCE This contract is not valid unless bilaterally executed. Subject to mutual agreement Orange County, Florida, hereby enters into a contract subject to the following:
AFFIDAVIT. If the Agency-Assisted Contractor or Contractor(s) contend that the contract has been awarded to a SBE, the Agency-Assisted Contractor or Contractor(s) shall, at the same time also submit to the Agency a SBE Application for Certification and its accompanying Affidavit completed by the SBE owner. However, a SBE that was previously certified by the Agency shall submit only the short SBE Eligibility Statement.
AFFIDAVIT. An affidavit in the form required by the Escrow Agent to remove any standard exceptions from the Title Policy, including mechanics’ liens, parties in possession and similar matters, together with a GAP Indemnity.
AFFIDAVIT. I, [Name of Affiant], of legal age, [Civil Status], [Nationality], and residing at [Address of Affiant], after having been duly sworn in accordance with law, do hereby depose and state that:
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:
AFFIDAVIT. An affidavit in the form required by the Title Company to remove any standard exceptions, including mechanics’ liens, parties in possession and similar matters, together with a GAP Indemnity.
AFFIDAVIT. The undersigned, , as , and on behalf of , having been duly sworn under oath, certifies that in the year , it performed that portion of the Services described in Exhibit 1 of the Agreement in accordance with the terms of the Agreement, to the extent described in the attached Full-Year Assessment Form and that it spent that portion of funds obtained from the City in connection with that Agreement on the Services described in Exhibit 1, to the extent described in the attached Full-Year Assessment Form . The Full-Year Assessment Form shall be in the form prescribed by the City and shall contain such level of detail as the City may require from time to time. Nothing in this Affidavit may be construed as limiting Contractor’s obligations under the Agreement. All terms not defined in this Affidavit will be as defined in the Agreement. Under penalty of perjury, I certify that I am authorized to execute this Affidavit on behalf of the Contractor, that I have personal knowledge of the certifications made in this Affidavit, and that they are true and correct. NAME OF CONTRACTOR: Signature of Authorized Officer Name of Authorized Officer (Print or Type) State of County of Sworn to and acknowledged before me by [title] of contracting party] this day of , 20 . [name of signatory] as [name of Signature of Notary FULL-YEAR ASSESSMENT FORM THIS ITEM IS SATISFIED BY THE SUBMISSION OF ALL FOUR QUARTERLY REPORTS FOR THE CONTRACT YEAR EXHIBIT 8
AFFIDAVIT. On this __ day of _________, 20__, before me appeared the above‑signed, known or identified to me personally, who, being first duly sworn, did say that s/he is the authorized representative of Contractor and that this document was signed on behalf of Contractor. Notary Public: My term expires (date): SCHEDULE K-6 CONTRACTOR’S FINAL CLAIM WAIVER AND RELEASE UPON FINAL PAYMENT (To be executed by Contractor with the invoice for final payment) STATE OF TEXAS COUNTY OF CAMERON The undersigned, Bechtel Oil, Gas and Chemicals, Inc. (“Contractor”), has been engaged under a contract with Rio Grande LNG, LLC (“Owner”) to furnish certain materials, equipment, services, and/or labor for the construction of improvements to the Rio Grande Natural Gas Liquefaction Facility Project, together with all improvements and appurtenances attendant thereto (the “Facility”), which is located near Brownsville, Texas, and more particularly described as follows: south of the Brownsville-Port Xxxxxx Highway and north of the Brownsville Ship Channel in Cameron County near Brownsville, Texas. Upon receipt of the sum of U.S. $___________________________ (amount in invoice for final payment), Contractor waives and releases all claims, demands, actions, causes of actions or other rights at law, in contract, tort, equity or otherwise (except those concerning lien or bond rights which are separately waived pursuant to TEX. PROP. CODE XXX. § 53.284 by the Contractor’s Conditional Waiver and Release on Final Payment, which is executed concurrently with this form) that Contractor has, may have had or may have in the future against Owner for payment for work, materials, equipment, services, labor, and other items performed under the contract with Owner. This Waiver and Release applies to all facts, acts, events, circumstances, changes, constructive or actual delays, accelerations, extra work, disruptions, interferences and the like which have occurred, or may be claimed to have occurred prior to the date of this Waiver and Release, whether or not known to Contractor at the time of the execution of this Waiver and Release. Contractor represents that all of its obligations, legal, equitable, or otherwise, relating to or arising out of its work on the Facility have been fully satisfied (except for that work and obligations that survive the termination or expiration of the contract, including warranties and correction of defective work), including, but not limited to, payment to subcontractors and e...
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 thereforeand 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: ___________________________ 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 and BUSINESS ASSOCIATE ADDENDUM TO CONTRACT NO. YXX-XXX related to BUSINESS ASSOCIATE ASSURANCE OF COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) PRIVACY, BREACH AND SECURITY RULES AND THE FLORIDA INFORMATION PROTECTION ACT (FIPA) THIS ADDENDUM is by and between, ORANGE COUNTY, FLORIDA (the “County”), a charter county and political subdivision of the State of Florida, located at 000 Xxxxx Xxxxxxxx Xxxxxx, Orlando, Florida 32801, on behalf of its COUNTY DE...
