Schedule C- contract clauses certificaiton.pdf

This is a Contract Clauses Certification form from the Michigan Department of Transportation (MDOT) for FY 2019. The form requires completion and signature by organizations that have contracts or project authorizations with MDOT. It serves as an acknowledgment that the signer has reviewed the Contract Clauses and will comply with all applicable clauses for FTA-funded contracts during the application year.

The form requires the name of the authorized signer, legal organization name, title of authorized signer, signature, and date. For organizations with master agreements with MDOT, the organization name must match exactly as it appears on the master agreement, and multiple certifications must be submitted for organizations with multiple contracts. The authorized signer must either be the same as the master agreement signer or an individual with legal authority to sign project authorizations, with the option to modify authorized signers through a signature resolution.