CERTIFICATION STATEMENT. Under Section 231.006, Family Code, the vendor or applicant certifies that the individual or business entity named in this contract, bid, or application is not ineligible to receive the specified grant, loan, or payment and acknowledges that this contract may be terminated and payment may be withheld if this certification is inaccurate. The contractor understands that it is the contractor’s responsibility to verify whether a child support obligor who is more than 30 days delinquent is the sole proprietor, partner, shareholder or owner with an ownership interest of at least 25%.
CERTIFICATION STATEMENT. I CERTIFY that the information on this Permanent Agreement/Policy statement and all related attachments is true and correct to the best of my knowledge and that the Institution herein named is in compliance with the audit requirements stated in 7 CFR Part 3052. The Institution named herein accepts final financial and administrative responsibility for management of an effective food service, and further agrees to comply with all requirements as specified under 7 CFR 226. An Institution/Sponsoring Organization certifies that all key staff (as defined by Wisconsin Department of Public Instruction) has attended annual program training and documentation is on file in support of this certification. The Institution certifies that neither it nor any of its principals have been declared ineligible to participate in any other publicly funded program by reason of violating that programs’ requirements. The Institution certifies that neither it or any of its principals has been convicted of any activity that occurred in the past seven years and that indicated a lack of business integrity. (A lack of business integrity includes fraud, antitrust violations, embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, receiving stolen property, making false claims obstructing justice, or any other activity indicating a lack of business integrity as defined by the state agency.) Institutions and individuals providing false certifications will be placed on the National Disqualified List and will be subject to any other applicable civil or criminal penalties. The Institution further certifies that a screening process is in place to scrutinize any criminal convictions of board members that may disqualify them from performing program administrative functions. I understand that this information is being provided in connection with receipt of federal funds and that deliberate misrepresentation may subject me to prosecution under applicable state and federal criminal statutes. By continuing to operate the CACFP after the enactment or issuance of any changed or new statutes and regulations applicable to the Program covered by this Agreement and any changed and new instructions, policy memoranda, guidance and other written directives interpreting these statutes and regulations, the sponsoring organization agrees to comply with them. If the institution does not wish to comply with any changed or new items, the institution must seek to term...
CERTIFICATION STATEMENT. A Federal-aid project certification statement by the District Director of Transportation Development for each project is no longer required; however, Districts are responsible for ensuring that all Federal-aid requirements are met as described in this chapter.
CERTIFICATION STATEMENT. I certify that the information I have provided is accurate and complete, and I understand that any false information may be cause for denial, reduction, and/or immediate repayment of all aid. I understand that purposely submitting false or misleading information on this worksheet may lead to fines, sentencing to jail, or both. Please allow the Office of Financial Aid 10-15 business days for review. If awarded, you will be notified by the Office of Financial Aid of the award. The TEACH Xxxxx is awarded in the amount of $4,000 per academic year. Please note that the awarding of the TEACH Grant may require adjustment to other forms of financial aid (e.g. loans, grants, scholarships). Signature Date For Office Use Only: Received by: Date:
CERTIFICATION STATEMENT. I certify that the lease agreement is entered into within the authority of the law, is with my approval and that the person signing the same for the State immediately below is authorized to do so. _______________________________________________________ ___________________ Lessee Date APPROVALS OF THE STATE OF KANSAS: For Use by State of Kansas Signatories Only _______________________________________________________ ___________________ Attorney, Department of Administration Date _______________________________________________________ ___________________ Director of Facilities and Property Management, Department of Administration Date _______________________________________________________ ___________________ Secretary of Administration Date
CERTIFICATION STATEMENT. The INDIVIDUAL VOLUNTEER HEALTHCARE PROVIDER agrees to:
CERTIFICATION STATEMENT. I understand and agree that:
CERTIFICATION STATEMENT. CERTIFICATION The undersigned represents that he/she has full authority to execute this document on behalf of the Offeror, and that to the best of the Offer’s knowledge and belief, the representations, certifications and other statements contained herein are true, complete, and accurate. The Offeror further certifies that it will notify the Contracting Officer of any changes to these representations and certifications. The representations and certifications made by the Offeror, as contained herein, concern matters within the jurisdiction of an agency of the United States, and the making of a false, fictitious, or fraudulent representation or certification may render the maker subject to prosecution under Title 18, Untied States code, Section 1001. Offeror: _______________________________________ Address: _______________________________________ _______________________________________ _______________________________________ Signature:______________________________ Name (typed):______________________ Title/capacity:_________________________ Date:________________________ Seal/attestation (End of Provision) [End of Section] SECTION L - INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFEROR L.1 FAR 52.215-1 INSTRUCTIONS TO OFFERORS—COMPETITIVE ACQUISITION (Jan 2004)
CERTIFICATION STATEMENT. CERTIFICATION The undersigned represents that he/she has full authority to execute this document on behalf of the Offeror, and that to the best of the Offer’s knowledge and belief, the representations, certifications and other statements contained herein are true, complete, and accurate. The Offeror further certifies that it will notify the Contracting Officer of any changes to these representations and certifications. The representations and certifications made by the Offeror, as contained herein, concern matters within the jurisdiction of an agency of the United States, and the making of a false, fictitious, or fraudulent representation or certification may render the maker subject to prosecution under Title 18, Untied States code, Section 1001. Offeror: Address: Signature: Title/capacity: Seal/attestation Name (typed): Date: (End of Provision) [End of Section]
CERTIFICATION STATEMENT. I elect to contribute to the 403(b) tax-sheltered annuity/investment plan offered by Baltimore County Public Schools (BCPS). With respect to salary earned on a biweekly basis, I understand and agree that this SRA: • Is legally binding, governed by IRS Code, and irrevocable for amounts earned with this SRA in effect; • Shall remain in effect for the duration of my employment with BCPS or until you give written authorization to change or cancel it. You may change the amount of your contribution of your 403(b) company by completing a new SRA and sending it to the Office of Benefits and by giving the company written notice of changes or cancellation at least 10 days in advance of the next regularly scheduled payroll deduction. Any change in contributions will apply only to your unearned salary and not to amounts already earned. • Contributions may not exceed the dollar limits on elective deferrals contained in IRS Code. The dollar limit on contributions applies to ALL annuity contracts or custodial accounts in which you elect to invest. An additional contribution can be made if you are age 50 or older by the end of the calendar year. • This Agreement is subject to the terms and conditions of BCPS’ 403(b) Retirement Plan. Employee Signature Date
