Get 792b 2004-2024

U.S. USDA Form usda-rus-792b According to the Paperwork Reduction Act of 1995 an agency may not conduct or sponsor and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0572 0107. The time required to complete this information collection is estimated to average 1 minute per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information* U*S* Department of Agriculture Rural Utilities Service CERTIFICATE OF CONTRACTOR AND INDEMNITY AGREEMENT Line Extensions certifies that he or she is the TITLE NAME OF CONTRACTOR the Contractor in a Construction Contract No* dated 20 entered into between the Contractor and NAME OF RUS BORROWER the Owner and that he or she is authorized to and does make this Certificate and Indemnity Agreement on behalf of said Contractor in order to induce the Owner to make payment to the Contractor in accordance with the provisions of the said contract. The undersigned further says that all persons who have furnished labor in connection with the Section of the project represented by the inventory dated 20 in the amount of have been paid in full that all manufacturers material suppliers and subcontractors which furnished any materials or services or both for the said Section of the project have been paid in full that no lien has been filed against the project and no person has any right to claim any lien against the project. project the Contractor will indemnify and hold harmless and does hereby undertake and agree to indemnity and hold harmless the Owner from any claim or lien arising out of the negligence or other fault of the Contractor in respect of the performance of the contract which may have been or may be filed against the Owner. Date President This Certificate must be signed with the full name of the Contractor. If the Contractor is a partnership this Certificate must be signed in the partnership name by a partner. If the Contractor is a corporation this Certificate must be signed in the corporate name by a duly authorized officer. The valid OMB control number for this information collection is 0572 0107. The time required to complete this information collection is estimated to average 1 minute per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data needed and completing and reviewing the collection of information* U*S* Department of Agriculture Rural Utilities Service CERTIFICATE OF CONTRACTOR AND INDEMNITY AGREEMENT Line Extensions certifies that he or she is the TITLE NAME OF CONTRACTOR the Contractor in a Construction Contract No* dated 20 entered into between the Contractor and NAME OF RUS BORROWER the Owner and that he or she is authorized to and does make this Certificate and Indemnity Agreement on behalf of said Contractor in order to induce the Owner to make payment to the Contractor in accordance with the provisions of the said contract. The undersigned further says that all persons who have furnished labor in connection with the Section of the project represented by the inventory dated 20 in the amount of have been paid in full that all manufacturers material suppliers and subcontractors which furnished any materials or services or both for the said Section of the project have been paid in full that no lien has been filed against the project and no person has any right to claim any lien against the project. .