CERTIFICATION OF COMPLIANCE WITH CRITERIA FOR APPROVAL OF LEASE UNDER EXPEDITED PROCEDURE
Name of Lessee __________________________________
Name of Lessor __________________________________
Equipment to be Leased ___________________________
Term of Lease ___________________________________
Amount of Lease _________________________________
Interest Rate _____________________________________
BEFORE ME, the undersigned authority, personally came and appeared ______________________________________ who declared that he is the ___________ for the Lessee, and does hereby certify that:
The proposed lease agreement 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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If the lease agreement transfers ownership of the leased property to the Lessee at the end of the lease term or contains an option to purchase the leased property at a nominal price, it has been let in accordance with the public bid laws.
The Lessee has excess or sufficient revenues to cover annual debt service on the lease pursuant to the provisions of R.S. 33:2922.
The total amount of the lease does not exceed the greater of $100,000 or 10 percent of the Lessee's annual revenues.
The Lessee has not been in default on any debt obligation within the previous five years.
The following documents are attached:
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Lessee's Agent or Authorized Officer
Sworn to and subscribed before me, this _____ day of _______, ________, at __________________, Louisiana.
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Notary Public
La. Admin. Code tit. 71, § III-907