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DocuSign Envelope ID: 04E136D1 -507C- 4219- BF16- 446F8D2192F8 <br />at Risk Team agrees that in the event a third party brings any action against the County or any of its officials or employees <br />to obtain disclosure of the document the CM at Risk Team will indemnify and hold harmless the County and each <br />organization's affected officials and employees from all costs, including attorney's fees, incurred by or assessed against <br />any defendant, of defending against such action. The CM at Risk Team also agrees that at the County's request the CM <br />at Risk Team will intervene in any such action and assume all responsibility for defending against it, and that the CM at <br />Risk Team's failure to do so will relieve the County of all further obligations to protect the confidentiality of the document. <br />EXHIBIT A <br />Certification Form <br />(Provide separate Certification for each Joint Venture or Partnership entity) <br />**COMPANY NAME ** <br />* *SEAL ** <br />I HEREBY CERTIFY THAT THE INFORMATION CONTAINED IN THIS RESPONSE TO THE REQUEST FOR <br />PROPOSALS IS CORRECT AND TRUTHFUL TO THE BEST OF MY KNOWLEDGE AND BELIEF. <br />This the _ day of , 2015. <br />By: <br />Title <br />License number under which the project will be executed: <br />