Common use of State Boilerplate Affirmation Clause Clause in Contracts

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate contract clauses (as contained in the 2016 OAG/ IDOA Professional Services Contract Manual) in any way except for the following clauses which are named below: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2021 OAG/ IDOA Professional Services Contract ManualManual or the 2021 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate contract clauses (as contained in the 2016 2015 OAG/ IDOA Professional Services Contract Manual) in any way except for the following clauses which are named below: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate contract clauses (as contained in the 2016 OAG/ IDOA Professional Services Contract Manual) in any way except for the following clauses which are named below: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2018 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2018 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate 's standard contract clauses (as contained in the 2016 2020 OAG/ IDOA Professional Services Contract ManualManual or the 2020 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s 's knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate 's standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2018 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s 's knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate contract clauses (as contained in the 2016 2015 OAG/ IDOA Professional Services Contract Manual) in any way except for the following clauses which are named below: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm The State Educational Institution affirms under the penalties of perjury that I have it has not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2021 OAG/ IDOA Professional Services Contract ManualManual or the 2021 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorState Educational Institution, or that the undersigned is the properly authorized representative, agent, member or officer of the ContractorState Educational Institution. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorState Educational Institution, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor State Educational Institution attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2018 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorGrantee, or that the undersigned is the properly authorized representative, agent, member or officer of the ContractorGrantee. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorGrantee, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract Grant other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the ContractGrant, the Contractor Grantee attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate 's standard contract clauses (as contained in the 2016 2019 OAG/ IDOA Professional Services Contract ManualManual or the 2019 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s 's knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate 's standard contract clauses (as contained in the 2016 2021 OAG/ IDOA Professional Services Contract ManualManual or the 2021 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ NONE The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s 's knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate contract clauses (as contained in the 2016 2014 OAG/ IDOA Professional Services Contract Manual) in any way except for the following clauses which are named below: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. FurthermoreIn Witness Whereof, if Contractor and the undersigned has knowledge that a state officerState have, employeethrough their duly authorized representatives, or special state appointeeentered into this Contract. The parties, as those having read and understood the foregoing terms are defined in IC 4-2-6-1, has a financial interest in the of this Contract, do by their respective signatures dated below agree to the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5terms thereof.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate 's standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2018 SCM Template) in any way except as follows: 46. Termination for the following clauses which are named below: _____________Default_____________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s 's knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate 's standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2018 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ N/A The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s 's knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2019 SCM Template) in any way except for as follows: inapplicable, modified or added Sections are identified in the following clauses which are named below: __________________________________________ body of this Contract. The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 OAG/ IDOA Professional Services Contract Manual2022 SCM Template) in any way except for as follows: inapplicable, modified or added Sections are identified in the following clauses which are named below: __________________________________________ body of this Contract. The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2021 OAG/ IDOA Professional Services Contract ManualManual or the 2021SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s 's Boilerplate contract grant clauses (as contained in the 2016 2015 OAG/ IDOA Professional Services Contract Manual) in any way except for the following clauses which are named below: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorGrantee, or that the undersigned is the properly authorized representative, agent, member or officer of the ContractorGrantee. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorGrantee, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract Grant Agreement other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the Contractgrant, the Contractor Grantee attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm The State Educational Institution affirms under the penalties of perjury that I have it has not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2018 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorState Educational Institution, or that the undersigned is the properly authorized representative, agent, member or officer of the ContractorState Educational Institution. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorState Educational Institution, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor State Educational Institution attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. [Modified] I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 OAG/ IDOA Professional Services Contract Manual2022 SCM Template) in any way except for as follows: inapplicable, modified or added Sections are identified in the following clauses which are named below: __________________________________________ body of this Contract. The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s 's knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm The State Educational Institution affirms under the penalties of perjury that I have it has not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2019 OAG/ IDOA Professional Services Contract ManualManual or the 2019 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorState Educational Institution, or that the undersigned is the properly authorized representative, agent, member or officer of the ContractorState Educational Institution. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorState Educational Institution, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor State Educational Institution attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate standard contract clauses (as contained in the 2016 2021 OAG/ IDOA Professional Services Contract ManualAgreement Manual or the 2021 SCM Template) in any way except for the following clauses which are named belowas follows: __________________________________________ Nondiscrimination. The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorParty, or that the undersigned is the properly authorized representative, agent, member member, or officer of the ContractorParty. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorParty, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract Agreement other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-4- 2-6-1, has a financial interest in the ContractAgreement, the Contractor Party attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, modified or changed or deleted the State’s 's Boilerplate contract clauses (as contained defined in the 2016 OAG/ OAG/IDOA Professional Services Contract Manual) in any way except for the following clauses which are named below: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorGrantee, or that the undersigned is the properly authorized representative, agent, member or officer of the ContractorGrantee. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorGrantee, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract Grant other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the ContractGrant, the Contractor Grantee attests to compliance with the disclosure requirements in IC 4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury The State Educational Institution affirms that I have it has not altered, modified, modified or changed or deleted the State’s Boilerplate contract clauses (as contained defined in the 2016 OAG/ OAG/IDOA Professional Services Contract ManualManual – State Educational Institution) in any way except for the following clauses which are named below: __________________________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the ContractorState Educational Institution, or that the undersigned is the properly authorized representative, agent, member or officer of the ContractorState Educational Institution. Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the ContractorState Educational Institution, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC §4-2-6-1, has a financial interest in the Contract, the Contractor State Educational Institution attests to compliance with the disclosure requirements in IC §4-2-6-10.5.

State Boilerplate Affirmation Clause. I swear or affirm under the penalties of perjury that I have not altered, modified, changed or deleted the State’s Boilerplate 's standard contract clauses (as contained in the 2016 2018 OAG/ IDOA Professional Services Contract ManualManual or the 2018 SCM Template) in any way except for the following clauses which are named belowas follows: _____________35. Order of Precedence; Incorporation by Reference._____________________________ The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that the undersigned is the properly authorized representative, agent, member or officer of the Contractor. Further, to the undersigned’s 's knowledge, neither the undersigned nor any other member, employee, representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any sum of money or other consideration for the execution of this Contract other than that which appears upon the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or special state appointee, as those terms are defined in IC § 4-2-6-1, has a financial interest in the Contract, the Contractor attests to compliance with the disclosure requirements in IC § 4-2-6-10.5.