9. If your organization is not on the attached list, please include a copy of
Articles of Incorporation for your organization, roster of Board members and
Internal Revenue Service Tax Exempt status letter.
Applicants Statement
I have reviewed the foregoing application submitted by
(name of organization) proposing a contractual project to the County of San
Luis Obispo. I understand that the contract which the County will enter into
with the organization requires that the organization be responsible for any
damage claims or other liabilities arising out of the performance of the contract.
Applicant is able to provide proof of insurance to the County of San Luis
Obispo, with the County of San Luis Obispo named as an additional insured on
the policy for the project. Additionally, the applicant understands that he/she is
entering into a contract with the County of San Luis Obispo for the performance
of service for the County
and that the County is not making charitable gift to the
applicant. I have reviewed this application on behalf of the organization named
herein above. I am informed and believe that the applicant organization can and
will carry out the project as described.
I declare under penalty of perjury that the foregoing is true and correct.
Executed at, , California, on this
day of
, 20 .
By (Signature):
Print Name:
Title:
