CERTIFICATION OF COMPLIANCE WITH CRITERIA FOR APPROVAL OF FINANCING OF MOVABLES UNDER EXPEDITED PROCEDURE
Name of Entity: __________________________________
Equipment to be Purchased: ________________________
Term of Financing: _______________________________
Amount of Financing: _____________________________
Interest Rate: ____________________________________
Maximum Annual Debt Service:_____________________
BEFORE ME, the undersigned authority, personally came and appeared who declared that he/she is the _______ for the and does hereby certify that:
The proposed financing is being entered into for the purpose of acquiring movable property necessary to provide essential governmental services, more specifically the following:
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The borrower has sufficient revenues to repay the loan pursuant to the provisions of R.S. 33:2921.
The total amount of financing does not exceed the greater of $100,000 or 10 percent of the borrower's annual revenues.
The provisions of the public bid law, to the extent applicable, have been complied with.
The borrower has not been in default on any debt obligation within the previous five years.
The following documents are attached:
______________________________
Public Official
Sworn to and subscribed before me, this ____ day of ____, at ____________, Louisiana.
______________________________
Notary Public
La. Admin. Code tit. 71, § III-1107