395c RUS Form 395c - Certificate of Seller

OMB Control No. 0572-xxxx

Expiration Date: xx, 20xx

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-NEW. The time required to complete this information is estimated to average 30 minutes 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.

CERTIFICATE OF SELLER

AND INDEMNITY AGREEMENT

									, certifies that
he is the										of
	TITLE OR DESIGNATION
									, the Seller,
	NAME OF SELLER
in a contract No. No.o.				dated		entered into between the
Seller and							, the Buyer, for the
		NAME OF RUS BUYER
furnishing, delivery, and installation of								equipment and

Materials (hereinafter called the Project), which bears the Rural Utilities Project Designation

: and that he is authorized to and does make

this Certificate on behalf of the Seller in order to induce the Rural Utilities Service to advance moneys to the Buyer for the purpose of payment by the Buyer to the Seller and to induce the Buyer to make payment to the Seller, in accordance with the provisions of the Contract.

Undersigned further certifies that all persons who have furnished labor in connection with the Project have been paid in full; that all manufacturers, materialmen and subcontractors which furnished any materials or services, or both, for the Project have been paid in full; that no lien have been filed against the Project and no person has any right to claim any lien against the Project.

If the Buyer pays the Seller the total amount due under the Contract, which the

Seller agrees is $ , including $ for taxes paid by the Seller, the Seller will indemnify and hold harmless and does hereby undertake and agree to indemnify and hold harmless the Buyer from any claim or lien arising out of the performance of the Contract which may have been or may be filed against the Buyer.

DATE			SIGNATURE OF SELLER

RUS FORM 395c (Issued )