- 4 -
|
CERTIFICATION
I, the undersigned, acting on behalf of the Applicant named below, hereby certify and agree to the following:
• The information submitted by the Applicant to the Missouri Department of Economic Development (DED) in connection with the Project is true and
correct and such information is consistent with documents provided to lenders, other government programs, or investors. The Applicant hereby
authorizes DED to verify such information from any source;
• The Applicant, contact person(s), owners, or signors identified in the application (Please mark appropriate box. If you mark “Have” or “Are”, please
provide an explanation on another sheet of paper):
a) Have Have not--committed a felony, is currently charged with commission of a felony, or is currently on parole or probation;
b) Are Are not--delinquent with respect to any non-protested federal, state or local taxes or fees;
c) Have Have not--filed (or is about to file) for bankruptcy, unless otherwise disclosed to DED; or
d) Have Have not--failed to fulfill any material obligation under any other state or federal program;
• There are no pending or threatened liens, judgments, or material litigation against the Applicant or any person identified on the application which is
likely to have a material impact on the Applicant’s viability;
• Neither the operations of the Project itself nor the receipt of incentives for the Project would violate any existing agreement;
• The Applicant has obtained or is capable of obtaining all necessary federal, state and local permits and licenses for the Project;
• I certify that the Applicant does NOT knowingly employ any person who is an unauthorized alien and that the Applicant has complied with federal law
(8 U.S.C. § 1324a) requiring the examination of an appropriate document or documents to verify that each individual is not an unauthorized alien.
• I certify that the Applicant is enrolled and will participate in a federal work authorization program as defined in Section 285.525(6), RSMo. with respect
to employees working in connection with the activities that qualify applicant for this program. I certify that the Applicant will maintain and, upon
request, provide DED documentation demonstrating Applicant’s participation in a federal work authorization program with respect to employees
working in connection with the activities that qualify Applicant for this program.
• I certify that the Applicant shall include in any contract it enters with a subcontractor in connection with the activities that qualify applicant for this
program, an affirmative statement from the subcontractor that such subcontractor is not knowingly in violation of Section 285.530.1, RSMo, and shall
not be in violation during the length of the contract. In addition the Applicant will receive a sworn affidavit from each such subcontractor under
penalty of perjury, attesting that the subcontractor’s employees are lawfully present in the United States. I certify that the Applicant will maintain and
provide DED and the Missouri Department of Revenue (DOR) access to documentation demonstrating compliance with this paragraph.
• I understand that, pursuant to Section 285.530.5, RSMo, a general contractor or subcontractor of any tier shall not be liable under Section 285.525 to
285.550 when such general contractor or subcontractor contracts with its direct subcontractor who violates Section 285.530.1, if the contract binding
the contractor and subcontractor affirmatively states that the direct subcontractor is not knowingly in violation of Section 285.530.1 and shall not
henceforth be in such violation and the contractor or subcontractor receives a sworn affidavit under the penalty of perjury attesting to the fact that
the direct subcontractor’s employees are lawfully present in the United States.
• I understand that if the Applicant is found to have employed an unauthorized alien, Applicant maybe subject to penalties pursuant to Sections
135.815, 285.025, and 285.535, RSMo.
• I understand that if the Applicant is found to have employed an unauthorized alien in Missouri and did not, for that employee, examine the
document(s) required by federal law, the Applicant shall be ineligible for any state-administered or subsidized tax credit, tax abatement or loan for a
period of five years following any such finding.
• I have read and understand the Missouri Works Program guidelines.
• I hereby agree to allow representatives of DED or DOR access to the property and applicable records as may be necessary for the administration of
this program.
• I certify under penalties of perjury that the above statements and information contained in the application and attachments are complete, true, and
correct to the best of my knowledge and belief.
I certify that I am an executive level representative of the Applicant and have the proper authority to execute this document on behalf of the Applicant and
that I am authorized to make the statement of affirmation contained herein. I also realize that failure to disclose material information regarding the
Applicant, any owners or individuals engaged in the management of the Applicant, or other facts may result in criminal prosecution.
Applicant Signature Print Name Title Date
STATE OF ________________________ SS. COUNTY OF __________________________________
On this ______ day of ______________________ in the year 20 ____ before me, ____________________________________________, a Notary
Public in and for said state, personally appeared __________________________________ [name of Corporate Officer / Member], ____________
______________ [Name of Corporation / Limited Liability Corporation], known to me to be the person who executed the within Agreement in
behalf of said Applicant and acknowledged to me that he or she executed the same for the purposes therein stated.
___________________________________ Notary Public My commission expires ________________________
MISSOURI DEPARTMENT OF ECONOMIC DEVELOPMENT 4 Revised August 2021
|