Legal Affidavit of Requirements

LEGAL AFFIDAVIT OF REQUIREMENTS

Affiant Name:    Capacity:

Affiant Address:

Requesting Party Name:    Requesting Party Address:

Date of Affidavit: Month Day Year

RECITALS

WHEREAS, the Affiant has personal knowledge of the facts stated herein and is authorized to make this affidavit on behalf of the Affiant in the capacity set forth above; and

WHEREAS, the Requesting Party has requested that Affiant certify and attest to the status and completion of certain requirements, conditions, permits, approvals and deliverables (collectively, the "Requirements") described in this affidavit; and

WHEREAS, Affiant has reviewed the applicable documents and has caused such inquiries and verifications as reasonably necessary to form the statements contained in this affidavit.

NOW, THEREFORE

Affiant certifies, under penalty of perjury, that the following statements are true and correct to the best of Affiant's knowledge, information and belief as of the date set forth above.

1. DEFINITIONS

For purposes of this affidavit, capitalized terms not otherwise defined herein shall have the following meanings: "Requirements" means the permits, approvals, certifications, documents, inspections, insurance coverages, trainings and other deliverables identified in Section 2; "Supporting Documents" means documentary evidence reasonably demonstrating satisfaction of a Requirement.

2. AFFIRMATION OF REQUIREMENTS

Affiant affirms that the following Requirements have been completed or provided in accordance with the applicable standards and timelines. Affiant must check the box and describe the Supporting Documents or, if not completed, provide an expected completion date.

a) Required Permits and Authorizations:
Permits obtained and in force.
Supporting Documents and remarks:

b) Insurance and Financial Requirements:
Required insurance coverages in effect.
Supporting Documents and policy numbers:

c) Training, Inspections, and Testing:
Required trainings, inspections, and tests completed.
Description, dates completed, and report references:

d) Other Requirements:    Status:

3. REPRESENTATIONS AND WARRANTIES

Affiant represents and warrants that: (a) Affiant has the authority and knowledge to make the statements contained in this affidavit; (b) the facts set forth in this affidavit are true, correct and complete; and (c) no material fact has been omitted that would render any statement herein misleading.

Affiant further represents that Supporting Documents identified in Section 2 are true copies of the original documents in Affiant's possession or control, and that, to Affiant's knowledge, such documents remain in full force and effect.

4. SUPPORTING DOCUMENTS

Affiant attaches or will make available to the Requesting Party the Supporting Documents evidencing satisfaction of the Requirements. Identify or list documents below:

5. CONTINUING OBLIGATIONS

Affiant acknowledges an ongoing obligation to notify the Requesting Party promptly in writing of any material change to the status of the Requirements or Supporting Documents. Affiant agrees to cure any deficiency within a commercially reasonable period and to provide updated documentation upon request.

6. REMEDIES AND INDEMNIFICATION

Affiant acknowledges that any materially false statement or omission in this affidavit that causes the Requesting Party to incur loss may give rise to remedies including but not limited to recovery of damages, injunctive relief, and indemnification for losses caused by such misrepresentation. Affiant agrees to indemnify and hold harmless the Requesting Party from claims arising out of Affiant's negligent or intentional misstatements.

7. NOTICES

8. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This affidavit shall be governed by and construed in accordance with the laws of the State of without regard to choice-of-law rules. This affidavit contains the entire statement by Affiant regarding the Requirements and supersedes all prior oral or written statements concerning the same. If any provision of this affidavit is held invalid, illegal or unenforceable, such provision shall be severed and the remaining provisions shall continue in full force and effect.

9. AMENDMENTS; WAIVER; COUNTERPARTS

No amendment, waiver or modification of any provision of this affidavit shall be effective unless in writing and signed by both Affiant and Requesting Party. Failure to enforce any provision shall not constitute a waiver of future enforcement. This affidavit may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument.

DECLARATION

I, the undersigned Affiant, declare under penalty of perjury under the laws of the State of that the foregoing is true and correct and that I am authorized to execute this affidavit on behalf of the Affiant named above.

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