Witness Name Address: THE SECRETARY OF STATE FOR EDUCATION Duly Authorised
Company Name The Members may change the name of the Company or operate under different names, provided a majority of the Members agree and the name complies with Section ▇▇-▇▇-▇▇▇ of the Act.
Full Name Position: ................................................ Position: ................................................ Date: ..................................................... Date: .....................................................
Contractor Name Business License #: Address: City, State, Zip Code: Telephone: Facsimile: Email: * If you are an independent contractor you are required to obtain a business license with the City of Thousand Oaks. Contractor certifies under penalty of perjury that Contractor is a Sole Proprietor Corporation Limited Liability Company Partnership Nonprofit Corporation Other [describe: ]
DHS Seal, Logo, and Flags The Contractor shall not use the Department of Homeland Security (DHS) seal(s), logos, crests, or reproductions of flags or likeness of DHS agency officials without specific FEMA pre-approval.