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Agmt05 Santa Clara, City of
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Agmt05 Santa Clara, City of
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Last modified
1/19/2006 4:36:02 PM
Creation date
1/19/2006 4:34:51 PM
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Template:
Agreement
Contractor Name
Santa Clara, City of
PROJECT NAME
HRS services
RMP File Number
304
Date
9/26/2005
MO Ref
05-171
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<br />AGREEMENT FOR THE PERFORMANCE OF SERVICES <br />BY AND BETWEEN <br />CITY OF SANTA CLARA, CALIFORNIA <br />AND <br />CITY OF REDWOOD CITY <br /> <br />EXHIBIT E <br /> <br />AFFIDAVIT OF COMPLIANCE WITH ETHICAL STANDARDS <br />[CITY OF SANTA CLARA] <br /> <br />I, EJ E It ,¿.¿/¿r , being first duly sworn, depose and say that I am <br />the [insert title or capacity] of City of Redwood City, a <br />chartered California Corporation, and I hereby state that I have read and understand the <br />language, entitled "ETHICAL STANDARDS FOR CONTRACTORS SEEKING TO <br />ENTER INTO AN AGREEMENT WITH THE CITY OF SANTA CLARA, CALIFORNIA" <br />(herein "Ethical Standards") set forth in Exhibit D. I have authority to make these <br />representations on my own behalf or on behalf of the legal entity identified herein. I have <br />examined appropriate business records and I have made inquiry of those individuals <br />potentially included within the definition of "Contractor" contained in the Ethical <br />Standards. <br /> <br />Based on my review of the appropriate documents and the necessary inquiry responses, I <br />hereby state that neither the business entity nor any individual(s) belonging to a category <br />identified in footnote #1 of Exhibit D [i.e., owner or co-owner of a sole proprietorship, <br />general partner, person who controls or has power to control a business entity, etc.] has <br />been convicted of anyone or more of the crimes identified in Exhibit D within the past <br />five (5) years. The above assertions are true and correct and are made under penalty of <br />peljury under the laws of the State of California. <br /> <br />CITY OF REDWOOD CITY <br />a California Corporation <br /> <br />\.j{¿./)(... '. p-...i!/Í .. <br />By ) ~ - YLCk-¿ . <br />Type or Print Name: '/ <br />Title <br /> <br />NOT ARY'S ACKNOWLEDGMENT TO BE ATTACHED <br /> <br />Please execute the affidavit and attach a notary public's acknowledgment of execution of <br />the affidavit by the signatory. If the affidavit is on behalf of a corporation, partnership, or other <br />legal entity, the entity's complete legal name and the title of the person signing on behalf of the <br />legal entity shall appear above. Written evidence of the authority of the person executing this <br /> <br />Affidavit of Compliance With Ethical Standards - Redwood City <br />Rev: 12/06/04 Exhibit E <br /> <br />Page 1 of 2 <br />
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