This certification and release must be signed by the
individual applicant or principal officer of the organization with the knowledge
of the matters contained herein and with legal authority to obligate the organization. The undersigned certifies: That all information contained herein is
accurate or represents a reasonable estimate of future operations based on the
data available at the time of the application and that there are no
misstatements or misrepresentations contained herein or in attachments. The individual applicant or organization will
comply with the federal laws that regulate Fair Labor, Civil Rights,
Accessibility, and other regulations and City requirements in this grant
application. The undersign hereby
release Community Vision Capital & Consulting, and their respective
officers, employees or agents, from any and all liability and/or responsibility
concerning damage to or loss of materials submitted to FormAssembly, whether or
not such damage or loss is caused by the negligence or intentional acts or
omissions of FormAssembly, its respective officers, employees or agents.