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 standard contract clauses (as contained in the 2018 OAG/IDOA Professional Services Contract Manual or the 2019 SCM Template) in any way except as follows: inapplicable, modified or added Sections are identified in the 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.
Appears in 2 contracts
Sources: Professional Services, Professional Services
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 standard Boilerplate contract clauses (as contained in the 2018 OAG/2020 OAG/ IDOA Professional Services Contract Manual or the 2019 SCM TemplateManual) in any way except as followsfor the following clauses which are named below: inapplicabledeleted, modified modified, or added Sections are identified in the 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 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- 6-10.5.
Appears in 2 contracts
Sources: Child Advocacy Center Contract, Child Advocacy Center Contract
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 's standard contract clauses (as contained in the 2018 OAG/OAG/ IDOA Professional Services Contract Manual or the 2019 SCM Template) in any way except as follows: inapplicable, modified or added Sections are identified in the 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- 6-10.5.
Appears in 1 contract
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 standard contract clauses (as contained in the 2018 OAG/OAG/ IDOA Professional Services Contract Manual or the 2019 SCM Template) in any way except as follows: inapplicable, modified or added Sections are identified in the 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- 6-10.5.
Appears in 1 contract
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 standard contract clauses (as contained in the 2018 OAG/2019 OAG/ IDOA Professional Services Contract Manual or the 2019 SCM Template) in any way except as follows: inapplicable, modified or added Sections are identified in the 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- 6-10.5.
Appears in 1 contract
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 standard contract clauses (as contained in the 2018 OAG/IDOA Professional Services Contract Manual or the 2019 2022 SCM Template) in any way except as follows: inapplicable, modified or added Sections are identified in Provision Applicable to Grants with tax-funded State Educational Institutions: "Separateness" of the body of this ContractParties-Deleted. 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 '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- 6-10.5.
Appears in 1 contract
Sources: Grant Agreement
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 standard contract clauses (as contained in the 2018 OAG/IDOA Professional Services Contract Manual or the 2019 2018 SCM Template) in any way except as follows: inapplicable, modified or added Sections are identified in the 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.
Appears in 1 contract
Sources: Professional Services
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 standard contract clauses (as contained in the 2018 OAG/IDOA Professional Services Contract Manual or the 2019 2022 SCM Template) in any way except as follows: inapplicable, Amendments -added Grant Funding-modified or HIPAA Compliance-added Sections are identified in the body of this Contract. Federal and State Third-Party Contract Provisions-deleted 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 '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- 6-10.5.
Appears in 1 contract
Sources: Grant Agreement