395a RUS Form 395a - CERTIFICATE OF COMPLETION

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 COMPLETION

(Including Installation)

		PROJECT DESIGNATION

In connection with the above referenced RUS financed project, the undersigned certify to the best of their respective knowledge and belief that:

1. The installation of equipment provided for pursuant to Contract No.					dated		,
including all approved amendments, (hereinafter called the ''Project'') between
		(Buyer) and
(Seller) has been completed as of			and is in all respects in strict compliance

with all the provisions of the Loan Contract, including specifications drawings, and all modifications thereof.

2. The Seller has delivered to the Buyer a Certificate of Seller certifying 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 has been filed against the Project and no person has any right to claim any lien against the Project.

3. All the required acceptance tests have been made on the equipment; results were satisfactory, and the Seller has furnished in writing to the Buyer the results of all tests.

4. All defects in workmanship and materials reported during the period of construction of the Project have been corrected.

5. The total cost of the Project as completed is
Dollars	(	$		)	Including $__________ in taxes paid by the Seller and $____________ in taxes paid by the Buyer

Dated this

day of

20

.

NAME OF BUYER				NAME OF ENGINEER
By				By
	BUYER’S SIGNATURE				ENGINEER’S SIGNATURE

RUS FORM 395a (Issued )