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LEARN.DO.LIVE. <br />COVID-19 Vaccination Requirement Declaration <br />This declaration is required for all suppliers,vendors and contractors working on-site at a Central <br />Washington University (CWU)location as of October 18,2021.The form must be electronically signed <br />using DocuSign.If you have questions email to purchasing office‡cwu.edu. <br />Pursuant to Governor Inslee's Proclamation 21-14.1(NPTOclamation"),as amended on August 20,2021, <br />and anytime thereafter,I hereby declare as follows: <br />1.The Company listed on this form ("Company")is a contractor with Central Washington University <br />(CWU)("University")as defined by the Proclamation. <br />2.Pursuant to Section 4 of the Proclamation,Central Washington University has elected to require <br />the Company to assume responsibility for the vaccination verification and accommodation <br />requirements included within the Proclamation and the Company agrees to assume those <br />responsibilities with respect to all of its employees that provide on-site services to the University. <br />3.The Company has met all of the vaccine verification and accommodation requirements included <br />within the Proclamation.This includes the requirement to obtain a copy or visually observe proof of <br />full vaccination against COVID-19for every current employee who is subject to the vaccination <br />requirement. <br />4.Any employee of the Company who is not fully vaccinated by October 18,2021,and is not <br />otherwise exempt from the vaccine requirement,will be prohibited from providing on-site services <br />to the University. <br />5.The Company agrees to submit additional signed declarations upon the request of and by the <br />date designated by the University. <br />6.The Company further agrees to cooperate with any investigation or inquiry the University makes <br />into the Company's compliance with the Proclamation.This includes providing information and <br />records upon request,except any information or records that the Company is prohibited by law <br />from disclosing. <br />Contracts and Procurement <br />400 E University Way •Ellensburg WA 98926-7480 •Office:509-963-1002 •Fax:509-963-2871 <br />Mitchell 2nd Floor ·Email:purchasing_office@cwu.edu • <br />Web:www.cwu.edulcontracts/contracts-purchasing-surplus-home <br />EEO/AAITITLEIX INSTITUTION •FOR ACCOMMODATIONEMAIL:DS@CWU.EDU. <br />This is an electronic communication from Central Washington University.