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Mount Rainier National Park 12/7/2018
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Mount Rainier National Park 12/7/2018
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Entry Properties
Last modified
12/18/2018 10:30:42 AM
Creation date
12/18/2018 10:30:34 AM
Metadata
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Contracts
Contractor's Name
Mount Rainier National Park
Approval Date
12/7/2018
Council Approval Date
12/5/2018
End Date
12/31/2020
Department
Parks
Department Project Manager
Euan Robertson
Subject / Project Title
Commercial Use Permit Summer Day Hiking
Tracking Number
0001536
Total Compensation
$2,245.00
Contract Type
Agreement
Contract Subtype
Interlocal
Retention Period
6 Years Then Destroy
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NPS Form 10-550(Rev. 11/2016) OMB Control No. 1024-0268 <br /> National Park <br /> Service <br /> Expiration Date: 11/15/2019 <br /> 13. Violations: <br /> To your knowledge, have you,your company, or any current or proposed employees been convicted or fined for violations <br /> of State, Federal, or local law within the last 5 years?Are you, your company, or any current or proposed employees now <br /> under investigation for any violations of State, Federal, or local law or regulation?See instructions. <br /> Yes ❑ No X If"Yes", please provide the following information.Attach additional pages, if necessary. <br /> Date of violation or incident under investigation: <br /> Name of business or person(s) charged: <br /> Please identify the law or regulation violated or under investigation: <br /> Please identify the State, municipality, or Federal agency that initiated the charges: <br /> Additional Detail (optional): <br /> (Results)Action Taken by Court: <br /> 14. Fee: <br /> Please include the Application Fee and Administrative Fee as outlined in Attachment C. <br /> 15. Signature: <br /> False, fictitious or fraudulent statements of representations made in this application may be grounds for denial or <br /> revocation of the Commercial Use Authorization and may be punishable by fine or imprisonment(U.S. Code,Title 18, <br /> Section 1001). All information provided will be considered in reviewing this application.Authorized Agents must attach <br /> proof of authorization to sign below. <br /> By my signature, I hereby attest that all my statements and answers on this form and any attachments are true, complete, <br /> and accurate to the best of my knowledge. <br /> 171?-1(S-- <br /> Signature 41111111111 Date <br /> Printed Name Title <br /> . �f OJ <br /> eQS Sit' I ?e,vFz 't� `v/e .4— <br /> NT : ST: <br /> i I Oa <br /> APPROVED AS TO FORM City Clerk <br /> JAMES D. ILES, C, Attor1-y <br /> Page 6 of 21 <br />
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